Background : It is always easy to perform one operation at one time. We have found a mixed type results in the literature about combined liver and colon Resection of Synchronous Colorectal liver metastasis. In selective patients it is safe and feasible in a well equipped center. Time and cost of surgery is important along with the tumor free margin of the specimen. Nevertheless chemotherapy remains important for micro-metastasis. Our aim was to remove the lower rectal tumor along with the metastatic liver resection.

Methods : A 63 years old male patient was a diagnosed case of carcinoma rectum. Tumor was 7 cm from the anal verge on colonoscopy. Radiological investigations confirmed tumor in left lobe and a small tumor in the right lob of liver. Lower anterior resection was done followed by left lateral and segment 7 liver resection. No any blood transfusion was required.

Results : Post operative recovery was uneventful. Patient was discharges on 15th postoperative day.

Conclusions : Usually surgeons prefer to operate case one at a time. It is also good for the safety of the patient. But in selected cases, we can go for two procedures in single anesthesia. This holds good in few cases of colorectal cancer with liver metastasis. It can be safely performed at quarterly referral center.