Aljiffry Murad, Alrajraji Mawaddah, Al-Sabah Salman, Hassanain Mazen
Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Saudi J Gastroenterol. 2014 Sep-Oct;20(5):315-8. doi: 10.4103/1319-3767.141694.
Laparoscopic approaches have been increasingly used in selected patients with either colorectal or liver cancer. However, simultaneous resection of colorectal carcinoma with synchronous liver metastases is still a subject of debate. The present case describes combined laparoscopic rectal and liver resections for a patient with primary rectal cancer and a synchronous liver metastasis utilizing a Pfannenstiel incision for specimen extraction. The operative time was 370 min and estimated blood loss was 400 mL. Postoperatively, the patient required parenteral analgesia for 48 h, resumed normal diet on day 3 and was discharged on day 7 after the operation. A laparoscopic approach utilizing a Pfannenstiel extraction incision may present an advantageous and attractive option for simultaneous laparoscopic rectal and liver resection in selected patients with the aim of improving short-term outcomes.
腹腔镜手术方法已越来越多地应用于部分结直肠癌或肝癌患者。然而，同时切除结直肠癌并伴有同步肝转移仍存在争议。本病例描述了一名原发性直肠癌伴同步肝转移患者接受腹腔镜直肠和肝脏联合切除术，采用耻骨上横切口取出标本。手术时间为370分钟，估计失血量为400毫升。术后，患者需要48小时的肠外镇痛，术后第3天恢复正常饮食，术后第7天出院。对于部分患者，采用耻骨上横切口取出标本的腹腔镜手术方法可能是同时进行腹腔镜直肠和肝脏切除术的一个有利且有吸引力的选择，旨在改善短期预后。
