Wu Deqing, Wu Wulin, Li Yong, Liang Shuntian, Wang Junjiang, Yao Xueqing, Jian Zhixiang
Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, People's Republic of China.
J BUON. 2017 Mar-Apr;22(2):437-444.
Laparoscopic hepatectomy is not a well-established treatment modality for colorectal liver metastases. Moreover, most reports have been limited to tumors in the anterolateral segments (segments 2, 3, 4b, 5, and 6). We evaluated the short- and long-term outcomes after laparoscopic hepatectomy for colorectal liver metastases located in all segments, including tumors located in the posterosuperior segments (segments 1, 4a, 7, and 8).
TThis retrospective study included 102 patients who underwent laparoscopic hepatectomy for colorectal liver metastases with radical intent between January 2009 and January 2016. The patients were divided into two groups (anterolateral and posterosuperior group) according to tumor location. The clinical and follow-up data of the two groups were retrospectively reviewed.
There was no 30-day postoperative mortality. Most of the postoperative 30-day complications were classified as minor complications (Clavien-Dindo classification). There was no difference in clinicopathologic characteristics between the two groups. Although posterosuperior group patients had significantly longer operative time (p=0.008) and postoperative hospital stay duration (p=0.041), as well as a greater blood loss (p=0.012), there was no significant difference in rate and severity of postoperative complications (p=0.314 and 1.000 respectively). During a median follow-up period of 41 months, the 5-year overall survival (OS) (p=0.449), and disease-free survival (DFS) (p=0.370) was no significant difference between the two groups.
Laparoscopic hepatectomy for colorectal liver metastases located in all segments of the liver can be safely performed in selected patients, with acceptable postoperative morbidity and oncologic results.
腹腔镜肝切除术并非治疗结直肠癌肝转移的成熟治疗方式。此外，大多数报告仅限于前外侧肝段（第2、3、4b、5和6段）的肿瘤。我们评估了对位于所有肝段的结直肠癌肝转移灶，包括位于后上肝段（第1、4a、7和8段）的肿瘤进行腹腔镜肝切除术后的短期和长期结果。
这项回顾性研究纳入了2009年1月至2016年1月间102例接受根治性腹腔镜肝切除术治疗结直肠癌肝转移的患者。根据肿瘤位置将患者分为两组（前外侧组和后上组）。对两组的临床和随访数据进行回顾性分析。
术后30天无死亡病例。术后30天的大多数并发症被归类为轻微并发症（Clavien-Dindo分类）。两组间的临床病理特征无差异。尽管后上组患者的手术时间（p=0.008）、术后住院时间（p=0.041）显著更长，失血量也更多（p=0.012），但术后并发症的发生率和严重程度无显著差异（分别为p=0.314和1.000）。在中位随访期41个月期间，两组间的5年总生存率（OS）（p=0.449）和无病生存率（DFS）（p=0.370）无显著差异。
对于肝脏所有肝段的结直肠癌肝转移灶，在选择的患者中可安全地进行腹腔镜肝切除术，术后发病率和肿瘤学结果均可接受。
