Settmacher U, Scheuerlein H, Rauchfuss F
Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07740, Jena, Deutschland,
Chirurg. 2014 Jan;85(1):24-30. doi: 10.1007/s00104-013-2566-0.
Most patients with colorectal liver metastases are treated within a multimodal therapy regime whereby liver resection is a key point in the curative treatment concept. The achievement of an R0 situation is of vital importance for long-term survival. Besides general operability and the assessment of comorbidities, resection depends on the quality of liver parenchyma (functional resectability) and the anatomical position of the tumor (oncological resectability). The improvement of operation techniques and perioperative medicine nowadays allow complex surgical procedures for metastasis surgery. This article presents the methods for the assessment of resectability and modern strategies of preoperative conditioning as well as approaches for extended liver resection.
大多数结直肠癌肝转移患者接受多模式治疗，其中肝切除是根治性治疗理念的关键。实现R0切除对长期生存至关重要。除了一般的可手术性和合并症评估外，肝切除还取决于肝实质的质量（功能可切除性）和肿瘤的解剖位置（肿瘤学可切除性）。如今手术技术和围手术期医学的进步使得转移性手术能够采用复杂的手术方法。本文介绍了可切除性评估方法、术前预处理的现代策略以及扩大肝切除的方法。
