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两例老年患者腹腔镜同期切除结直肠癌并同步肝转移灶

Two cases of laparoscopic simultaneous resection of colorectal cancer and synchronous liver metastases in elderly patients.

作者信息

Ito Tomoaki, Kushida Tomoyuki, Sakurada Mutsumi, Maekawa Hiroshi, Orita Hajime, Mizuguchi Konomi, Sato Koichi

机构信息

Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.

Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan.

出版信息

Int J Surg Case Rep. 2016;26:134-7. doi: 10.1016/j.ijscr.2016.07.030. Epub 2016 Jul 27.

Abstract

INTRODUCTION

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.

PRESENTATION OF CASES

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.

DISCUSSION AND CONCLUSION

Our results indicate that simultaneous laparoscopic resection of colorectal cancer and synchronous liver metastases is feasible and safe in elderly patients.

摘要

引言

腹腔镜结直肠癌切除术和腹腔镜肝脏手术被广泛认为是安全的。最近,有报道称,在经验丰富的中心进行原发性结直肠癌和肝转移瘤的同期腹腔镜切除在技术上是可行且安全的。然而,老年患者同期进行腹腔镜手术治疗结直肠癌和同时性结直肠癌肝转移的可行性尚未得到充分研究。在本研究中,报道了两例老年结直肠癌合并同时性肝转移患者接受同期腹腔镜切除治疗的病例。

病例介绍

一名83岁女性被诊断为升结肠癌并同时性肝转移。对原发性结肠癌和肝转移瘤进行了同期腹腔镜切除。随后在右肝叶发现另一个微小肝转移灶,采用手辅助射频消融(RFA)治疗。总手术时间为470分钟,术中失血340克。另一例为一名78岁男性,被诊断为升结肠癌并右肝叶同时性肝转移。对原发性结肠肿瘤和肝转移瘤进行了同期腹腔镜切除。总手术时间为471分钟,术中失血240克。两名患者术后病程均顺利。

讨论与结论

我们的结果表明,老年患者同期腹腔镜切除结直肠癌和同时性肝转移是可行且安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4c5/4972898/fa1c2fa6d481/gr1.jpg

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