Detailed Abstract
[Video Exhibition - Liver (Liver Disease/Surgery)]
[Liver Video Exhibition 1] DELAYED LAPAROSCOPIC LIVER RESECTION FOR SYNCHRONOUS LIVER METASTASIS COLO RECTAL CANCER (MCRC) AT SEGMENT 2-3 AND 7
Michael TENDEAN 1, Ferdinand TJANDRA 1
1 Digestive Surgery Division, General Surgery Department, Prof Dr. R.D. Kandou General Hospital, Indonesia
Background : Laparoscopic Liver Resection (LLR) is now an established procedure. Liver metastasectomy for Liver MCRC with curative intent is also a common procedure in this present era. The author would like to share his experience in this single case report of LLR for liver MCRC
Methods : This is a single case report of Male 62 y.o. with synchronous liver metastasis at segment 2-3 and 7. Previous low anterior resection for the primary cancer of middle third rectal adenocarcinoma was performed 9 months ago. Complete adjuvant chemotherapy with the regiment of m-folfox 6 was administered. But during surveillance, the liver MCRC persisted at segment 2-3 and 7, and a LLR approach was chosen for the liver metastasectomy.
Results : LLR was performed in Delayed Sequence. An anatomical left lateral sectionectomy followed by non anatomical liver resection segment 7 was performed. Adhesions from previous surgery hinders the procedure. Total operation time is around 3 hours, intermittent pringle maneuver using Huang loop was administered, with the intra-operative blood loss was at ± 500 cc. Harmonic scalpel were used as energy device and endostaplers also helped in the left lateral sectionectomy part. Post hepatectomy liver failure, bile leak, and any other morbidities and mortalities were not found in 30 day post op surveillance.
Conclusions : LLR for liver MCRC is a relevant and dependable procedure, hence an experienced team is needed. Post operative systemic therapy still needed after the LLR to minimize the risk of reccurency.
Methods : This is a single case report of Male 62 y.o. with synchronous liver metastasis at segment 2-3 and 7. Previous low anterior resection for the primary cancer of middle third rectal adenocarcinoma was performed 9 months ago. Complete adjuvant chemotherapy with the regiment of m-folfox 6 was administered. But during surveillance, the liver MCRC persisted at segment 2-3 and 7, and a LLR approach was chosen for the liver metastasectomy.
Results : LLR was performed in Delayed Sequence. An anatomical left lateral sectionectomy followed by non anatomical liver resection segment 7 was performed. Adhesions from previous surgery hinders the procedure. Total operation time is around 3 hours, intermittent pringle maneuver using Huang loop was administered, with the intra-operative blood loss was at ± 500 cc. Harmonic scalpel were used as energy device and endostaplers also helped in the left lateral sectionectomy part. Post hepatectomy liver failure, bile leak, and any other morbidities and mortalities were not found in 30 day post op surveillance.
Conclusions : LLR for liver MCRC is a relevant and dependable procedure, hence an experienced team is needed. Post operative systemic therapy still needed after the LLR to minimize the risk of reccurency.
SESSION
Video Exhibition
Exhibition Hall 03/27 ~ 03/29 ALL DAY