title: Two cases of laparoscopic simultaneous resection of colorectal cancer and synchronous liver metastases in elderly patients.
abstract: BACKGROUND
  The laparoscopic resection of colorectal cancer and laparoscopic liver surgery are widely considered to be safe. Recently, it has been reported that the simultaneous laparoscopic resection of primary colorectal cancer and liver metastasis is technically feasible and safe when it is performed at experienced centers. However, the feasibility of simultaneous laparoscopic procedures for colorectal cancer and synchronous colorectal liver metastases in elderly patients has not been studied sufficiently. In this study, two cases in which elderly patients with colorectal cancer and synchronous liver metastases were treated with simultaneous laparoscopic resection are reported.
  
  
  METHODS
  An 83-year-old female was diagnosed with ascending colon cancer and synchronous hepatic metastases. Simultaneous laparoscopic resection of the primary colon cancer and the liver metastasis was performed. Another tiny hepatic metastasis was subsequently detected in the right hepatic lobe. It was treated with hand-assisted radiofrequency ablation (RFA). The total operative time was 470min, and 340g of intraoperative blood loss occurred. The other case involved a 78-year-old male who was diagnosed with ascending colon cancer and synchronous hepatic metastasis in the right hepatic lobe. Simultaneous laparoscopic resection of the primary colon tumor and liver metastasis was performed. The total operative time was 471min, and 240g of intraoperative blood loss occurred. The postoperative courses of both patients were uneventful.
  
  
  CONCLUSIONS
  Our results indicate that simultaneous laparoscopic resection of colorectal cancer and synchronous liver metastases is feasible and safe in elderly patients.
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan. Electronic address: tomo-ito@juntendo.ac.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kushida
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Sakurada
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maekawa
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Orita
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Konomi
authors.initials: K
authors.lastname: Mizuguchi
authors.affiliation: Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sato
keywords: Case report; Colorectal cancer; Liver metastasis; Simultaneous laparoscopic resection; Synchronous colorectal liver metastasis