title: Laparoscopic major hepatectomy can be safely performed with colorectal surgery for synchronous colorectal liver metastasis.
abstract: BACKGROUND
  The optimal strategy for resectable synchronous colorectal liver metastases remains controversial. Although some authors advocate a staged treatment, an increasing number of studies have reported that combined colorectal and liver resection is safe. Laparoscopic combined resection in primary colorectal cancer with synchronous liver metastases has been reported but there are no specific data for major liver resections. In the present study, we evaluated the feasibility of a simultaneous entirely laparoscopic procedure, in the light of the benefits of laparoscopy in both colon and liver surgery, and discussed the benefits of this strategy.
  
  
  METHODS
  Two cases are presented of totally laparoscopic major liver resections associated with laparoscopic colorectal resections for synchronous liver metastases with the emphasis on the technical aspects. Duration of surgery, blood loss and post-operative outcome were evaluated.
  
  
  RESULTS
  Laparoscopic right hepatectomy or left hepatectomy with simultaneous colon resection for liver metastasis was feasible and safe with only one suprapubic 5-mm trocar added to the usual trocar sites. The mean duration of surgery was 327 min with a mean estimated blood loss of 200 ml. The post-operative course was uneventful.
  
  
  CONCLUSIONS
  In selected patients, laparoscopic major hepatectomies for unilobular synchronous metastases can be safely performed simultaneously with colorectal surgery.
authors.affiliation: Departments of General Surgery Radiology, Antoine Béclère Hospital, AP-HP, Clamart, France.
authors.forename: Hadrien
authors.initials: H
authors.lastname: Tranchart
authors.forename: Papa Saloum
authors.initials: PS
authors.lastname: Diop
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Lainas
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pourcher
authors.forename: Laurence
authors.initials: L
authors.lastname: Catherine
authors.forename: Dominique
authors.initials: D
authors.lastname: Franco
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Dagher
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D014057:Tomography, X-Ray Computed