Casaccia Marco, Famiglietti Federico, Andorno Enzo, Di Domenico Stefano, Ferrari Chiara, Valente Umberto
Advanced Laparoscopy Unit, General and Transplant Surgery Department, St. Martino Hospital, University of Genoa, Italy.
JSLS. 2010 Jul-Sep;14(3):414-7. doi: 10.4293/108680810X12924466006765.
We report the case of a 68-year-old female patient affected by rectal cancer and a synchronous metastatic lesion measuring 8 cm in diameter in the left hepatic lobe. After a laparoscopic ultrasonography exploration of the liver to detect possible occult metastases, a simultaneous colorectal resection and a left hepatic lobectomy including a partial resection of segment IV were performed. Five ports were used for the entire procedure. The resected specimens were extracted through a Pfannenstiel incision. The procedure was completed laparoscopically. Total operative time was 455 minutes with negligible intraoperative blood loss. The postoperative hospital stay was 12 days. At 4-month follow-up, the patient recovered completely. A computed tomography scan performed at this time showed no signs of recurrent disease. This report confirms the feasibility of the laparoscopic approach to simultaneous hepatic and colorectal resections in stage IV rectal cancer. The known advantages of the miniinvasive approach could make such complex procedures more endurable.
我们报告了一例68岁女性直肠癌患者，其左肝叶有一个直径8厘米的同步转移灶。在对肝脏进行腹腔镜超声检查以检测可能的隐匿性转移后，同时进行了结直肠切除术和左肝叶切除术，包括IV段部分切除。整个手术使用了五个端口。切除标本通过耻骨上横切口取出。手术通过腹腔镜完成。总手术时间为455分钟，术中失血可忽略不计。术后住院时间为12天。在4个月的随访中，患者完全康复。此时进行的计算机断层扫描显示没有复发疾病的迹象。本报告证实了腹腔镜方法用于IV期直肠癌同期肝和结直肠切除的可行性。微创方法的已知优势可使此类复杂手术更易于耐受。
