title: Synchronous totally laparoscopic management of colorectal cancer and resectable liver metastases: a single center experience.
abstract: OBJECTIVE
  The simultaneous management of primary colorectal cancer and synchronous liver metastases has been reported extensively in open surgery. Data regarding feasibility, safety, and outcomes of the laparoscopic procedure is emerging from the experience of a few surgical centers. This paper aims at discussing the technique and results of a one-step laparoscopic approach for colorectal cancer and liver metastases resection on a series of 35 patients.
  
  
  METHODS
  Between January 2008 and December 2013, 18 males and 17 females (median age 71 years) underwent colorectal and hepatic laparoscopic resection for colorectal metastatic cancer.
  
  
  RESULTS
  Thirty-five colorectal resections and 66 liver resections were performed; no conversion to open surgery has been indicated. Median blood loss was 200 ml, median operative time 240 min, and median hospital stay was 8 days (range 4-30). According to Clavien-Dindo classification, two class II complications, two class IIIb complications, and one class IV complication were recorded. Two high-risk patients died within 30 days from surgery.
  
  
  CONCLUSIONS
  This series confirms the feasibility of synchronous laparoscopic colorectal and hepatic resections. To ensure the best outcomes, a careful selection of patients is needed. However, most patients can benefit from this surgical approach.
authors: Department of Surgery, POLL-ASL 5, Via V. Veneto 197, 19100, La Spezia, Italy.
authors: Stefano
authors: S
authors: Berti
authors: Elisa
authors: E
authors: Francone
authors: Michele
authors: M
authors: Minuto
authors: Pierfrancesco
authors: P
authors: Bonfante
authors: Carlo
authors: C
authors: Sagnelli
authors: Claudio
authors: C
authors: Bianchi
authors: Alessandra
authors: A
authors: Tognoni
authors: Emilio
authors: E
authors: Falco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D000075202:Contraindications; D005260:Female; D006488:Hemostasis, Surgical; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged