• Zisun Kim, Gui-Ae Jeong, Jun-Cheol Chung, Chong-Woo Chu, Eung-Jin Shin, and Hyung-Chul Kim.
• Department of Surgery, Bucheon Hospital, Soonchunhyang University College of Medicine Bucheon, Korea.
• Hepato Gastroenterol. 2009 Mar 1; 56 (90): 508-11.

AbstractSurgical resection of liver metastases from colorectal cancer can offer long-term survival and cure in patients with metastatic colorectal cancer isolated to the liver. We present a case of a recurrent liver metastasis from rectal cancer, managed with ante-situm liver resection under total vascular exclusion and venovenous bypass with hypothermic perfusion. A 58-year-old man, who was diagnosed with liver metastasis from rectal cancer underwent a left lateral sectionectomy in January 2006. A recurrent lesion developed 1 year after the first hepatectomy. The tumor was 5 cm in size, locating at segments I, IV, and VIII. It was involved in the origin of middle hepatic vein and retro-hepatic vena cava. We performed ante-situm liver resection under total vascular exclusion and venovenous bypass with hypothermic perfusion. The patient remains well without recurrence for 12 months after the last operation. Ante-situm technique made it easy to approach and completely removes the recurrent lesion locating at hardly accessible site and having the incomplete removal risk by conventional liver resection. The authors also reconfirmed that repeat hepatectomy is valuable in recurrent colorectal liver metastases.

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