title: Simultaneous resection of colorectal cancer and synchronous liver metastases: initial experience of laparoscopy for colorectal cancer resection.
abstract: OBJECTIVE
  Although laparoscopy is accepted for treatment of colorectal cancer, there is no established consensus for its use when resection of synchronous liver metastases is performed simultaneously. The purpose of this study was to evaluate whether laparoscopic colorectal resection with simultaneous resection of synchronous liver metastases was technically feasible and whether it may be a therapeutic option.
  
  
  METHODS
  Ten patients underwent laparoscopic resection for primary colorectal cancer, combined with synchronous resection of liver metastases.
  
  
  RESULTS
  The primary tumor location was in the sigmoid colon in 3 patients and the rectum in 7. All laparoscopic colorectal resections were successful, with no conversion to open surgery. Simultaneously, there were 7 conventional open and 3 laparoscopy-assisted liver resections. The median total operating time was 446 (range 300-745) min, including 222 (range 152-313) min for colorectal resection. The median total estimated blood loss was 175 (range 30-1,200) ml, including 10 (range 0-550) ml for colorectal resection. There was no major morbidity, except 1 patient who developed decubitus.
  
  
  CONCLUSIONS
  This preliminary report suggests that laparoscopic resection for sigmoid colon and rectal cancer, combined with synchronous resection of liver metastases, is a safe and feasible procedure in selected patients.
authors.affiliation: Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiyoshi
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kuroyanagi
authors.forename: Akio
authors.initials: A
authors.lastname: Saiura
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Rintaro
authors.initials: R
authors.lastname: Koga
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Konishi
authors.forename: Masashi
authors.initials: M
authors.lastname: Ueno
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Oya
authors.forename: Makoto
authors.initials: M
authors.lastname: Seki
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D012811:Sigmoid Neoplasms / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome