Abstract: Aim To explore the feasibility of a simultaneous entirely laparoscopic procedure, in the light of the benefits of laparoscopy in both rectal and liver surgery, and discussed the surgical techniques and benefits of this strategy. Methods One case is presented of totally laparoscopic left lobe liver resections associated with laparoscopic colorectal resections for synchronous liver metastases with the emphasis on the technical aspects. Duration of surgery, blood loss and post-operative outcome were evaluated. Results Laparoscopic left hepatectomy with simultaneous colon resection for liver metastasis was feasible and safe. The mean duration of surgery was 190 min with a mean estimated blood loss of 300 ml. The postoperative course was uneventful. Discussion In selected patients, laparoscopic major hepatectomies for unilobular synchronous metastases can be safely performed simultaneously with colorectal surgery.

Key words: Laparoscope, Rectal cancer, Anterior approach liver resection

摘要： 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。

关键词: 腹腔镜, 直肠癌, 前入路肝切除