[Case Report of a Patient Who Underwent Open Left Hepatic Lobectomy Followed by Robot-Assisted High-Anterior Resection after Preoperative Chemotherapy for Multiple Simultaneous Liver Metastases of Rectal Cancer]

A woman in her 60s visited our hospital after colonoscopy revealed a circumferential type 2 lesion located 10 cm from the anal verge. Computed tomography revealed metastases in liver S4 and S8. The regional lymph nodes were markedly enlarged, compressing the sciatic nerve. The patient was diagnosed with unresectable advanced rectal cancer (cT4aN2bM1a, cStage Ⅳa), and treated with 5 courses of FOLFOXIRI+bevacizumab. The patient subsequently underwent open left lobectomy and cholecystectomy. One month later, a robotic high anterior resection of the primary tumor was performed. Although the patient had undergone laparotomy, robotic surgery was used to ensure complete R0 resection. Liver-first approaches may offer greater benefit for certain patient populations than other treatment strategies, including prior or concurrent resection of the primary lesion. Robotic surgery may also be a viable option for primary colorectal cancer even after open surgery.