title: Simultaneous colorectal and liver resections for synchronous colorectal metastases.
abstract: BACKGROUND
  The surgical strategy for the treatment of colorectal cancer and synchronous hepatic metastases remains controversial. Many surgeons fear anastomotic leakage and intraperitoneal abscesses when performing a one-step procedure. They prefer a two-step procedure with a liver resection 2 to 3 months after resection of the colorectal primary lesion.
  
  
  METHODS
  We analysed medical records from April 1994 to April 2002 for a total of 42 patients with colorectal cancer and synchronous liver metastases who underwent simultaneous liver and colorectal resections with a primary anastomosis. Special attention was paid to data on surgical procedures, postoperative morbidity, and mortality.
  
  
  RESULTS
  Forty-two patients, 24 men and 18 women, were studied. Median operating time was 6.50 hours (3.75-11.0 hours), and median blood loss was 1522 ml (range 288 to 5650 ml). Postoperative complications included pleural effusion in 4 patients, ileus in 3, anastomotic leakage in 2, intraperitoneal pelvic abscesses in 1, pneumonia in 1, bile leakage in 1, atelectasis in 1, and wound infection in 1. There was no perioperative mortality.
  
  
  CONCLUSIONS
  Simultaneous colorectal resection with a primary anastomosis and hepatectomy for synchronous liver metastases is considered a safe procedure.
authors.affiliation: Department of Surgery, Jichi Medical School, Tochigi, Japan. h-ssnm@jichi.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Sasanuma
authors.forename: Y
authors.initials: Y
authors.lastname: Yasuda
authors.forename: F V
authors.initials: FV
authors.lastname: Mortensen
authors.forename: K
authors.initials: K
authors.lastname: Yamashita
authors.forename: Y
authors.initials: Y
authors.lastname: Nihei
authors.forename: N
authors.initials: N
authors.lastname: Houjou
authors.forename: H
authors.initials: H
authors.lastname: Chiba
authors.forename: A
authors.initials: A
authors.lastname: Shimizu
authors.forename: M
authors.initials: M
authors.lastname: Okada
authors.forename: H
authors.initials: H
authors.lastname: Nagai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome