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用于肝结直肠癌转移的微创肝脏手术

Minimally Invasive Liver Surgery for Hepatic Colorectal Metastases.

作者信息

Nassour Ibrahim, Polanco Patricio M

机构信息

Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8548, USA.

Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8548, USA ; Veterans Affairs North Texas Health Care System, Dallas, TX, USA.

出版信息

Curr Colorectal Cancer Rep. 2016 Apr;12(2):103-112. doi: 10.1007/s11888-016-0316-7. Epub 2016 Mar 8.

Abstract

Minimally invasive surgery has been cautiously introduced in surgical oncology over the last two decades due to a concern of compromised oncological outcomes. Recently, it has been adopted in liver surgery for colorectal metastases. Colorectal cancer is a major cause of cancer-related death in the USA. In addition, liver metastasis is the most common site of distant disease and its resection improves survival. While open resection was the standard of care, laparoscopic liver surgery has become the standard of care for minor liver resections. Laparoscopic liver surgery provides equivalent oncological outcomes with better perioperative results compared to open liver surgery. Robotic liver surgery has been introduced as it is believed to overcome some of the limitations of laparoscopy. Finally, laparoscopic radio-frequency ablation and microwave coagulation can be used as adjuncts in minimally invasive surgery to complement or replace surgical resection when not possible.

摘要

在过去二十年中,由于担心肿瘤学治疗效果不佳,微创外科手术在外科肿瘤学领域一直被谨慎采用。最近,它已被应用于结直肠癌肝转移的肝脏手术中。在美国,结直肠癌是癌症相关死亡的主要原因。此外,肝转移是远处疾病最常见的部位,切除肝转移灶可提高生存率。虽然开放切除术曾是标准治疗方法,但腹腔镜肝脏手术已成为小范围肝脏切除术的标准治疗方法。与开放肝脏手术相比,腹腔镜肝脏手术能提供相当的肿瘤学治疗效果,且围手术期结果更好。机器人肝脏手术已被引入,因为人们认为它能克服腹腔镜手术的一些局限性。最后,腹腔镜射频消融和微波凝固可作为微创手术的辅助手段,在无法进行手术切除时补充或替代手术切除。

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