title: Simultaneous Resection of Colorectal Cancer and Liver Metastases through Hand-assisted Laparoscopic Surgery: Preliminary Exploration.
abstract: OBJECTIVE
  To describe the initial experience of simultaneous resection of colorectal cancer and liver metastases through hand-assisted laparoscopy (HALS).
  
  
  METHODS
  After endotracheal general anesthesia, patients were placed in the Trendelenburg with lithotomy position. A 5-cm longitudinal subumbilical port was created, and the Lap Disc device was placed and pneumoperitoneum was established. A laparoscope was inserted to explore the liver and the whole pelvic cavity. The surgeon stood on the right side or between the patient's legs, and a 10-mm trocar was placed in the abdominal wall based upon the location of the tumor. The liver and the colorectal lesion were reselected with the assisted-hand through the Lap Disc to establish the possibility of resection, the tumor margin, and metastasis.
  
  
  RESULTS
  Simultaneous resection of colorectal cancer and liver metastases through HALS were successful in all eight patients with operating time of 2-4 h. Average intraoperative blood loss was 100-300 ml, and no severe postoperative complications were observed. The average length of postoperative hospital stay was 7.5 days.
  
  
  CONCLUSIONS
  HALS for simultaneous resection of colorectal and metastatic liver cancer has the advantages of safety, feasibility, minimal invasion, shorter operation time, reduced operative difficulty less pain and rapid recovery.
authors.forename: Caizhao
authors.initials: C
authors.lastname: Lin
authors.forename: Sen
authors.initials: S
authors.lastname: Lu
authors.forename: Changlin
authors.initials: C
authors.lastname: Tang
authors.forename: Qinsong
authors.initials: Q
authors.lastname: Sheng
authors.forename: Zhe
authors.initials: Z
authors.lastname: Pan
authors.forename: Wenbin
authors.initials: W
authors.lastname: Chen
authors.forename: Shen
authors.initials: S
authors.lastname: Yan
authors.forename: Jianjiang
authors.initials: J
authors.lastname: Lin
authors.forename: Shusen
authors.initials: S
authors.lastname: Zheng
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D003082:Colectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D058733:Hand-Assisted Laparoscopy / Q000009:adverse effects / Q000295:instrumentation; D018475:Head-Down Tilt; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D007902:Length of Stay; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D056888:Patient Positioning; D011183:Postoperative Complications / Q000209:etiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome