Clinical Case of Laparoscopic Simultaneous Resection of the Dorsoventral Segment of the Liver and Transverse Colon Resection
Burlaka A.1,2, Skyba V.2, Zemskov S.2, Mykytyuk A.1, Rozhkova V.1, Beznosenko A.1, Sorokin B.3
- 1Nonprofit Organization «National Cancer Institute», Kyiv, Ukraine
- 2Bogomolets National Medical University, Kyiv, Ukraine
- 3Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
Summary. Approximately 50% of patients with colorectal cancer (CRC) develop metastatic liver involvement, with synchronous metastases identified in 15–20% of cases, significantly worsening the oncological prognosis. Surgical treatment remains the gold standard, with R0 resection being the primary objective for both the primary tumor and metastatic lesions. In patients with limited liver involvement and a satisfactory general condition, simultaneous resections may be considered. However, major liver resections (≥3 segments) are generally performed in a staged manner due to a higher risk of complications. Laparoscopic resection of the primary CRC tumor is widely accepted as the standard of care, and the feasibility of minor liver resections (<3 segments) has been confirmed in randomized trials. Nevertheless, evidence regarding the safety of laparoscopic simultaneous resections in synchronous colorectal liver metastases remains limited. No standardized protocols exist for trocar placement or patient positioning in interventions involving multiple abdominal regions. Similar experiences have been described in publications and surgical atlases addressing minimally invasive liver transplantation. Furthermore, laparoscopic procedures involving posterosuperior liver segments are considered technically complex in current guidelines and should be performed in expert centers. Objective. The aim of this study is to present a clinical case of successful laparoscopic simultaneous resection of liver metastases in segments S7 and S4, combined with resection of the transverse colon. Materials and methods. The surgical procedure was performed at the National Cancer Institute (Kyiv, Ukraine) with the involvement of a multidisciplinary surgical team. Conclusions. The laparoscopic surgical approach in patients with colorectal cancer and limited liver metastases may offer advantages over open surgery.
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