Mayo Clinic, Mayo Clinic Alix School of Medicine, Rochester, MN. Electronic address: https://twitter.com/timrengers.
Department of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester.
Surgery. 2023 Jul;174(1):119-122. doi: 10.1016/j.surg.2023.02.032. Epub 2023 Apr 5.
Liver resection is potentially curative for patients with colorectal liver metastasis, but an advanced understanding of tumor biology and improved adjuvant therapies have facilitated an ongoing evolution of metastatic resection, even in the setting of a significant metastatic disease burden. As indications for surgery have expanded, preferred techniques and timing have been debated. This commentary reviews the merits of anatomic versus non-anatomic approaches to colorectal liver metastasis resection, considering oncologic outcomes, overall survival, and conflicting theories in the pathophysiology of the metastatic liver spread.
肝切除术对结直肠癌肝转移患者具有潜在的治愈作用,但对肿瘤生物学的深入了解和辅助治疗的改善促进了转移性肝切除的不断发展,即使在存在大量转移病灶的情况下也是如此。随着手术适应证的扩大,人们对解剖性和非解剖性肝切除术式的优缺点展开了争论,包括肿瘤学结果、总生存以及转移性肝扩散的病理生理学中的相互矛盾的理论。