ObjectiveTo investigate the therapeutic strategy of simultaneously undergoing laparoscopic right hemihepatectomy for colorectal cancer with massive hepatic metastases. MethodsA patient diagnosed as colorectal cancer with massive hepatic metastases was conducted with clinic multidisciplinary diagnosis and treatment, including rigorous preoperative evaluation (residual liver volume measurement), and then laparoscopic resection of colorectal cancer was performed simultaneously with anatomic right hemihepatectomy and descending colon single cavity stoma, as well as right hemihepatic occlusion and preocclusion of inferior vena cava etc. were conducted during the operation to prevent intraoperative bleeding. ResultsThe surgery procedure of the patient was successful, and post-surgery pathology was moderately differentiated adenocarcinoma of the rectum, which the entire wall of the intestine was involved and the formation of periintestinal cancer nodules was seen. Only 3 of 13 lymph nodes had metastasis, and hepatic tumor was consistent with hepatic metastasis from colorectal cancer. Standard chemotherapy was continuously employed after surgery, CT reexamination of liver and lung 6 months after surgery presented no obvious recurrence of metastatic lesions. ConclusionFor patients with possible-radical-resection colorectal cancer with massive hepatic metastases, adequate preoperative evaluation should be conducted, and laparoscopic resection of colorectal cancer performed simultaneously with hemihepatectomy is safe and effective. For patients with initial symptoms as epigastric pain, elevation of tumor markers CEA and CA199, and hepatic space-occupying lesion, electronic colonoscopy to investigate colorectal carcinoma with hepatic metastasis is suggested improving, so as to avoid missed diagnosis.

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