完全腹腔镜下直肠癌根治合并肝左叶转移癌规则左半肝

目的 总结腹腔镜下一期行直肠癌根治、前入路左半肝切除的适应症和手术技巧。方法 分析我院一例直肠癌合并左肝多发转移的患者采用腹腔镜下直肠癌根治、规则性左半肝切除术。结果 手术时间190 min，术中出血300ml，无明显手术并发症，切口一期愈合。术后14d给予化疗。术后随访5个月，无局部复发、远处转移、及切口处肿瘤种植发生。结论一期行腹腔镜直肠癌根治合并左半肝规则切除，局限在单叶的肝多发转移灶行规则肝切除是安全可行的。

Discussion of complete laparoscopic radical gesection of rectal cancer combined with metastatic cancer of left lobe of liver by regular left hemi-hepatectomy in anterior approach

Objective To explore the feasibility of a simultaneous entirely laparoscopic procedure in both rectal and liver surgery and discuss the techniques of the operating procedure and benefits of this strategy. Methods One patient with colon cancer and synchronous liver metastasis was performed totally laparoscopic left lobe liver resections and combined with laparoscopic colorectal resections.The surgical skills,duration of surgery,blood loss and post-operative outcome were evaluated.Results Laparoscopic left hepatectomy with simultaneous colon resection was successfully completed. The mean duration of surgery was 190 min with a mean estimated blood loss of 300 mL. No complications were found. Conclusion Regarding the patient suffered from colon cancer with unilobular synchronous liver metastases, laparoscopic radical resection of colon cancer combined with major hepatectomy is feassible.