To evaluate the safety and efficacy of one-stage laparoscopic radical resection of colorectal cancer combined with extensive hepatectomy for synchronal liver metastasis from colorectal cancer.

Clinical data of 15 patients with colorectal cancer complicated with synchronal liver metastasis admitted to the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2016 to December 2019 were retrospectively analyzed. Among them, 9 patients were male and 6 female, aged from 44 to 75 years with a median of 53 years. Primary diseases were right colon cancer (n=5), left colon cancer (n=1), sigmoid colon cancer (n=5) and rectal cancer (n=4). Intrahepatic metastasis were located in the left lobe (n=9), in the right lobe (n=5), and in the middle lobe (n=1). The informed consents of all patients were obtained and the local ethical committee approval was received. One-stage laparoscopic radical resection of colorectal cancer combined with extensive hepatectomy(≥3 liver segments) was performed. Surgical condition and postoperative efficacy were observed.

Operations in all 15 patients were completed successfully. No patient was converted to open surgery. The surgical procedures included left hemihepatectomy + sigmoidectomy in 5 cases, left hemihepatectomy + Dixon operation in 3 cases, left hemihepatectomy + left hemicolectomy in 1 case, right hemihepatectomy +right hemicolectomy in 4 cases, right hemihepatectomy + Dixon operation in 1 case, and middle lobe resection + right hemicolectomy in 1 case. The median operation time was 200(150-360) min. Intraoperative blood loss was 200(100-350) ml. No blood transfusion was performed during the operation. Postoperatively, 1 patient developed bile leakage and 2 cases of pleural effusion. No severe complications, such as intestinal leakage, bleeding, liver failure, infection and death, were noted. The length of postoperative hospital stay was 10(7-15) d. Postoperative adjuvant chemotherapy FOLFOX6/XELOX+ bevacizumab was performed. The follow-up time was 22(6-42) months. One patient suffered from residual liver metastasis, 1 case of lung metastasis, and 1 case of death due to multiple systemic metastases were observed during the follow-up. No recurrence or metastasis was observed in other patients.

One-stage laparoscopic radical resection of colorectal cancer combined with extensive hepatectomy is a safe and feasible therapy for patients with synchronal liver metastasis from colorectal cancer.