title: Laparoscopic and robot-assisted one-stage resection of colorectal cancer with synchronous liver metastases: a pilot study.
abstract: OBJECTIVE
  One-stage resection of primary colon cancer and synchronous liver metastases is considered an effective strategy of cure. A laparoscopic approach may represent a safe and advantageous choice for selected patients with the aim of improving the early outcome.
  
  
  METHODS
  Between January 2008 and October 2008, 7 patients underwent one-stage laparoscopic resection for primary colorectal cancer combined with laparoscopic or robot-assisted liver resection.
  
  
  RESULTS
  A total of five laparoscopic left-colon, one right-colon, and one rectal resections were performed. Three patients underwent preoperative left-colon stenting and two received neoadjuvant chemotherapy. The patient with rectal cancer underwent neoadjuvant radiotherapy. Liver procedures included one bisegmentectomy (segments 2, 3), 3 segmentectomies, 6 metastasectomies, and four laparoscopic ultrasound-guided radiofrequency ablations (LUG-RFAs). One patient with multiple liver metastases was managed by a two-stage hepatectomy partially conducted by a totally laparoscopic approach. The overall postoperative morbidity was null. The median hospital stay was 10 days (range 7-10 days).
  
  
  CONCLUSIONS
  This pilot study suggests that laparoscopic one-stage colon and liver resection is feasible and safe. Robot assistance may facilitate liver resection, increasing the number of patients who may benefit from a minimally invasive operation.
authors.affiliation: Department of General, Vascular, Minimally Invasive and Robotic Surgery, San Matteo degli Infermi Hospital, Via Loreto, 3, 06049, Spoleto, Perugia, Italy. albertopatriti@gmail.com
authors.forename: Alberto
authors.initials: A
authors.lastname: Patriti
authors.forename: Graziano
authors.initials: G
authors.lastname: Ceccarelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Bartoli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Spaziani
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Lapalorcia
authors.forename: Luciano
authors.initials: L
authors.lastname: Casciola