Aim. To improve the surgical treatment results among patients with synchronous liver metastasis of colorectal cancer. Materials and methods. From 2012 to 2019, the analysis of the results of treatment of 60 patients with colorectal cancer and synchronous metastatic liver disease was carried out. The study sample was divided into 2 groups of patients. The group 1 consisted of 30 patients who got simultaneous resection of liver metastases and primary colorectal cancer. The group 2 consisted of other 30 patients who got stage resections: surgery for the primary tumor at the first stage, and liver surgery for metastases at the second.Results. The median operative time was 340 ± 21.1 minutes in the group 1. In the group 2 it was 255 ± 21.1 minutes and only the liver resection stage was assessed. The median blood loss in patients of the group 1 was 520,0 [200,0;800,1] ml, in the group 2 it was 500,0 [175,0;1300,0] ml. In general, we identified 5 cases of complications. In the postoperative period, 4 patients died. The average follow-up period is 23 months. One-year survival in group 1 was 92.6%, in group 2 – 100%, three-year – 85.2% and 89.6%. One-year disease-free survival in group 1 is 70%, in group 2 – 83.3%, three-year disease-free survival – 43.3% and 36.7%.Overall and disease-free survival rates didn’t differ significantly between the two treatment strategies. We detected significant effect on the disease-free and overall survival of regional lymph nodes metastasis (both p < 0.05).Conclusion. The long-term and immediate results of simultaneous surgery of synchronous liver metastasis of colorectal cancer are comparable to the results of the staged method of treatment. It indicates the safety and effectiveness of simultaneous procedure.

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Coloncancer is one of the first places in the structure of oncological diseases. According to statistics, edited by A.D. Kaprin, V.V. Starinskii, G.V. Petrova ofRussiafor 2015 was initially 36494 case of colorectal cancer, while 2% of cases are not diagnosed. Recurrence of colon cancer can occur at any stage regardless of the time elapsed after the radical treatment. Locoregionally originally is the presence of a tumor in the area of primary operation, which is represented by the primary tumor bed, the anastomosis, mesentery of the colon with lymphatic system, peritoneum and adjacent organs. Often after a diagnosis of “recurrence of the tumor in the colon” to the patient it is possible to provide only palliative care (colostomy, chemotherapy). The article cited clinical observation, confirming the important role of radiation techniques in determination of tactics of treatment of locoregional recurrence of the cecum cancer.

Background: About 15 to 25%  of colorectal cancer patients have synchronous liver metastasis at diagnosis. In the recent years, the strategy of simultaneous removal of colorectal cancer and liver metastases has been preferred. Development of minimally invasive technologies in abdominal and hepatopancreatobiliary surgery allows for active advance to fully laparoscopic approach to these types of interventions.Aim: Comparative analysis of simultaneous and isolated laparoscopic liver resections performed in the Department of Surgery, Russian Research Center of Roentgenoradiology (Moscow).Materials and methods: We have analyzed intra- and postoperative results of 29 laparoscopic procedures for metastatic liver disease. Group 1 included 14 patients who had undergone simultaneous laparoscopic primary tumor resection and laparoscopic liver resection for metastatic disease. Group 2 included 15 patients who had undergone isolated laparoscopic liver resection for metastatic lesions.Results: Mean (± SD) blood loss in the simultaneous and isolated procedures groups was 469 ± 176 and 408 ± 124  mL, respectively (p = 0.2), whereas the duration of surgeries was 296 ± 107  and 204 ± 82  min, respectively (p = 0.01). Conversion rate in the isolated resection group was higher (26% vs. 14%). This difference is to be explained by the learning curve in laparoscopic liver surgery. All liver resections in both groups were carried out in R0 mode. No deaths and significant complications were seen in any of the groups.Conclusion: The study demonstrated feasibility and safety of simultaneous, fully laparoscopic liver resections, including those for difficult localization of primary tumors and metastatic lesions.