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术前全身使用5-氟尿嘧啶不会增加肝切除的风险。

Preoperative systemic 5-fluorouracil does not increase the risk of liver resection.

作者信息

Parc Y, Dugué L, Farges O, Hiramatsu K, Sauvanet A, Belghiti J

机构信息

Department of Digestive Surgery, Hôpital Beaujon University of Paris VII, 100 Boulevard du Général Leclerc, F-92110 Clichy, France.

出版信息

Hepatogastroenterology. 2000 Nov-Dec;47(36):1703-5.

Abstract

BACKGROUND/AIMS: The majority of patients who underwent surgery for colorectal liver metastases have been previously treated with 5-FU either as adjuvant chemotherapy or as a primary treatment. We have performed a retrospective study to assess whether this chemotherapy increases the risk of liver resection.

METHODOLOGY

Mortality, morbidity and histology of the resected liver of two groups of patients having colorectal liver metastases who underwent major resection were studied. The first group included 17 patients who had received at least 2 courses of 5-FU chemotherapy within 3 months prior to liver resection. The second group included 18 patients who had received no chemotherapy and who were used as controls.

RESULTS

Perioperative mortality was nil. Intraoperative blood loss during liver resection (1 +/- 2.5 vs. 1.2 +/- 2 units) was similar in the two groups. Changes of liver function tests on days 2 and 5 were similar in the two groups. Morbidity rate was similar in the two groups (29 vs. 22%) with a mean duration of postoperative hospital stay of 19 +/- 9 days in the 5-FU group and 16 +/- 6 days in the control group. Although 7 (41%) patients in the 5-FU group had an abnormal parenchyma consistency as compared to only 3 (17%) in the control group, the pathological findings within the resected specimen were not different.

CONCLUSIONS

5-FU based systemic chemotherapy does not increase the risk of liver resections.

摘要

背景/目的:大多数接受结直肠癌肝转移手术的患者此前已接受过5-氟尿嘧啶(5-FU)治疗,作为辅助化疗或一线治疗。我们进行了一项回顾性研究,以评估这种化疗是否会增加肝切除的风险。

方法

对两组接受大手术切除的结直肠癌肝转移患者切除肝脏的死亡率、发病率和组织学进行了研究。第一组包括17例在肝切除前3个月内接受至少2个疗程5-FU化疗的患者。第二组包括18例未接受化疗的患者,作为对照组。

结果

围手术期死亡率为零。两组肝切除术中的失血量相似(1±2.5对1.2±2单位)。两组术后第2天和第5天肝功能检查的变化相似。两组的发病率相似(29%对22%),5-FU组术后平均住院时间为19±9天,对照组为16±6天。尽管5-FU组有7例(41%)患者的肝实质质地异常,而对照组只有3例(17%),但切除标本的病理结果并无差异。

结论

基于5-FU的全身化疗不会增加肝切除的风险。

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