Laparoscopic resections of the liver and the colon in patients with synchronous colorectal metastases: a case series

Abstract

Aim. To evaluate the results of laparoscopic simultaneous colorectal and liver resections in patients with synchronous liver metastases.
 Materials and methods. From July 2019 to July 2021 9 patients with synchronous liver metastases of colorectal origin underwent one-stage mini-invasive surgery in the Department of Oncology №4 City Clinical Oncological Hospital №1. There were 4 totally laparoscopic procedures while 5 patients had laparoscopic colon resection and an open hepatectomy. A laparoscopic rALPPS right hepatectomy with sigmoid colon resection was performed in one case.
 Results. There were no deaths during hospitalization or within 90 days after surgery. There were no severe complications requiring repeated surgeries or long-term intensive therapy (DindoClavien IIIBIVB grade). Two patients needed an ultrasound-guided drainage of hematoma and biloma, respectively. There was one case of grade A of liver failure and one case with prolonged antibacterial therapy caused by unclear fever. The average duration of interventions was 401121 min, the average volume of blood loss was 383331 ml. Mean post-operative hospital stay was 104 days.
 Conclusion. Our initial experience in the implementation of one-stage laparoscopic surgery in the treatment of patients with synchronous liver metastases of colorectal origin is promising and requires further research and analysis of long-term results.