The "Short-Cut" Laparoscopic Reverse Approach: A Novel Strategy for Synchronous Colorectal Cancer and Liver Metastases Requiring Major or Complex Procedures?

Abstract

To report on the feasibility and the safety of a novel strategy in patients with colorectal cancer and synchronous liver metastases (SLM) requiring major or complex procedures for both the primary and liver deposits. The strategy consisted in performing the two major procedures (liver first and colorectal) by laparoscopy within a short interval in order to keep both oncological advantages and short-terms outcome benefits. Two patients were treated with this strategy: one with a laparoscopic resection of segment VIII extended to the segment IVb followed by the laparosopic rectal resection; the second with a laparoscopic left hepatectomy with a microwave ablation of the lesion located in the segment VII followed by the laparoscopic resection of the sigmoid colon. Postoperative courses were uneventful. The "short-cut" laparoscopic reverse approach may represent an attractive option for patients requiring major liver and colorectal resections for SLM provided expertise in laparoscopic surgery in both fields is ensured.