Department of Colorectal Surgery, Gastrointestinal Institute, The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancunerheng Rd, Guangzhou, 510655, People's Republic of China.
J Gastrointest Surg. 2010 Dec;14(12):1974-80. doi: 10.1007/s11605-010-1284-x. Epub 2010 Jul 30.
Hepatic resection (HR) is the only option offering a potential cure for patients with synchronous colorectal cancer liver metastases (SCRLM). The optimal timing of HR for SCRLM is still controversial. This study aimed to determine whether simultaneous HR is similar to staged resection regarding the morbidity and mortality rates in patients with SCRLM.
Four hundred and five consecutive patients with SCRLM were treated with either simultaneous (n = 129) or staged (n = 276) HR. The postoperative complications were analyzed retrospectively according to the documented records and hepatectomy databases at the Gastrointestinal Institute.
Perioperative morbidity and mortality did not differ between simultaneous resections and staged resections for selected patients with SCRLM (morbidity, 47.3% versus 54.3%; mortality, 1.5% versus 2.0%, respectively; both p > 0.05). Simultaneous liver resections of three or more segments would not increase the rate of complications compared to staged resections (56.8% and 42.4%, respectively; p = 0.119). Meanwhile, patients with simultaneous resections experienced shorter duration of surgery and postoperative hospitalization time as well as less blood loss during surgery (all p < 0.05).
Simultaneous resections of colorectal cancer primary lesions and hepatic metastases were safe and could serve as a primary option for selected SCRLM patients.
肝切除术（HR）是为同时患有结直肠癌肝转移（SCRLM）的患者提供潜在治愈机会的唯一选择。SCRLM 行 HR 的最佳时机仍存在争议。本研究旨在确定同时行 HR 与分期切除术治疗 SCRLM 患者的发病率和死亡率是否相似。
405 例连续 SCRLM 患者接受了同期（n=129）或分期（n=276）HR。根据记录的病历和胃肠道研究所的肝切除术数据库，回顾性分析术后并发症。
同期切除和分期切除治疗选择的 SCRLM 患者的围手术期发病率和死亡率无差异（发病率分别为 47.3%和 54.3%；死亡率分别为 1.5%和 2.0%；均 P>0.05）。同时切除三个或更多肝段并不会增加并发症发生率，与分期切除相比（分别为 56.8%和 42.4%；P=0.119）。同时，同期切除组的手术时间、术后住院时间更短，术中出血量更少（均 P<0.05）。
同期切除结直肠原发肿瘤和肝转移灶是安全的，可以作为选择的 SCRLM 患者的主要治疗方案。
