title: Simultaneous liver metastasectomy at operation for primary colorectal or gynecologic malignancy.
abstract: BACKGROUND
  Treatment of synchronous resectable colorectal liver metastases has traditionally involved a staged surgical approach. Specialized centers have demonstrated good results with simultaneous resection. We aim to report our outcomes at the University of Mississippi Medical Center (UMMC) with simultaneous liver metastasectomy at the time of operation for primary colorectal or gynecologic malignancy
  
  
  METHODS
  From January 2010- September 2011, 6 patients underwent simultaneous resection of liver metastases and primary colorectal or gynecologic malignancy. Operative, postoperative, and pathologic data were retrospectively reviewed.
  
  
  RESULTS
  Four patients with colorectal primaries underwent simultaneous resection. One received abdominoperineal resection with resection of lesions in hepatic segments II and VII. A second received right hemicolectomy with en bloc resection of gallbladder and segments IV and V. The third and fourth patients both underwent left colectomy with resection of segments IV and V, respectively. All resections were non-anatomic, and frozen-sections were confirmed to be negative at the resection base. No patients suffered additional postoperative morbidity or mortality related to liver resection. Two patients had ovarian cancer with metastatic disease to the liver. The first underwent en bloc resection ofgallbladder and segments IV and V along with extensive debulking. The second had recurrent ovarian cancer with metastases with liver segments VI and VII. Both patients underwent simultaneous resection with no added postoperative morbidity or mortality attributed to hepatic resection. For gynecologic malignancy, the objective is to remove bulky disease, and although microscopic margins were positive, the goal of tumor load reduction was achieved.
  
  
  CONCLUSIONS
  Liver resection at the time of operation for primary colorectal or gynecologic malignancy can safely be performed with the benefit of avoiding morbidity of a second laparotomy without compromising safety.
authors.affiliation: Department of General Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA.
authors.forename: J Jarrett
authors.initials: JJ
authors.lastname: Corley
authors.forename: Mary Kinney
authors.initials: MK
authors.lastname: Corley
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lahr
authors.forename: David G
authors.initials: DG
authors.lastname: McIntosh
authors.forename: Mildred
authors.initials: M
authors.lastname: Ridgway
authors.forename: Naveed A
authors.initials: NA
authors.lastname: Ahmed
mesh_terms: D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D003952:Diagnostic Imaging; D005260:Female; D005704:Gallbladder / Q000473:pathology; D006801:Humans; D008099:Liver / Q000033:anatomy & histology; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed