Anterior approach for resection of metastatic liver tumors infiltrating the caudate lobe.

A 57-year-old woman with a cecal cancer underwent a curative, right hemicolectomy. One year after the operation, she was noted to have liver metastases with two focuses. One was 12 cm in diameter and was located mainly at the medial hepatic segment and infiltrating into the caudate lobe. The inferior vena cava and major hepatic vein were compressed and/or involved with the tumor. The patient underwent an extended left lobectomy using an anterior approach, which gave us sufficient visualization. The patient remains healthy 4 years after the operation. Hepatectomy using an anterior approach may be useful for expanding the surgical indications for metastatic disease.