Abstract
The patient was a 65-year-old man who underwent low anterior resection of the rectum with D3 lymph node dissection for rectal cancer and synchronous hepatic metastasis 2 years and 5 months earlier. The histopathological diagnosis was SS, N1, M1a (HEP), and chemotherapy with CapeOX regimen was started. The therapeutic effect of PR was attained. One year and 7 months earlier, he underwent the first stage of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), comprising S3 segmentectomy, ligation of the right branch of portal vein and hepatic resection, followed by the second stage of ALPPS (right lobectomy). He experienced hepatic metastases in three sites one year and 2 months earlier when he had been on adjuvant chemotherapy (UFT/LV). We thus started capecitabine + Bmab administration. Since no new lesions appeared and the chemotherapy had to be withdrawn due to hand-foot syndrome, laparoscopic partial hepatectomy for three metastatic lesions was performed. He has been doing well, as of 11 months after the last operation.
Hepatic metastasis of colorectal cancer can recur after surgery, so that we have to pay consideration to the possibility of rehepatectomy. This case where we were able to perform laparoscopic hepatectomy after ALPPS is presented here with a review of the literature.
