Liver Surgery Unit, Third Department of General Surgery, University of Milan, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
Surg Today. 2011 Sep;41(9):1184-9. doi: 10.1007/s00595-010-4527-2. Epub 2011 Aug 26.
Surgery remains the gold standard of treatment for colorectal cancer liver metastases (CLM). The only limitation of surgery for CLM is its technical feasibility, the key point being to leave enough remnant liver to ensure patient survival. This report describes a surgical procedure based extensively on ultrasound guidance, which allows for curative resection in one stage and also for multiple bilobar CLM. This strategy minimizes the need for two-stage hepatectomy and may thus overcome many of the limitations and consequences of a two-stage approach, such as the impossibility to complete the treatment approach in 20%-25% of patients and the amputation of major vascular structures, which can result in less technical solutions for CLM relapse.
手术仍然是结直肠癌肝转移（CLM）的治疗金标准。手术治疗 CLM 的唯一限制是其技术可行性，关键是要留下足够的剩余肝脏以确保患者的生存。本报告描述了一种广泛基于超声引导的手术程序，该程序允许在一个阶段进行治愈性切除，也允许对多个双侧 CLM 进行切除。这种策略最大限度地减少了两阶段肝切除术的需求，因此可能克服了两阶段方法的许多局限性和后果，例如 20%-25%的患者无法完成治疗方法和主要血管结构的截断，这可能导致针对 CLM 复发的技术解决方案减少。
