Briand D, Rouanet P, Kyriakopoulou T, Spiliotis J, Astre C, Saint-Aubert B, Joyeux H
Department of Surgical Oncology and Nutrition, Montpellier Cancer Institute, University of Montpellier, France.
Eur J Surg Oncol. 1994 Jun;20(3):219-24.
The main cause of death after hepatic resection for colorectal liver metastases is tumor recurrence. An improvement in survival may be achieved by resection of recurrent hepatic metastases as previously reported. In this paper we report our experience with 13 repeated liver resections in 11 patients. The post-operative mortality was 8% and the morbidity was 23% with two biliary tract fistulas and one recurrent pleural effusion. The median survival time from the first hepatic resection was 23 months, but differed according to the length of the disease-free interval (more than 1 year and less than 1 year: 49 and 17 months, respectively (P < 0.05). Our results suggest that repeated hepatic resection is technically a safe procedure and may be beneficial to selected patients. All candidates should be carefully evaluated pre-operatively for extrahepatic disease.
结直肠癌肝转移灶肝切除术后的主要死亡原因是肿瘤复发。如先前报道,再次切除复发性肝转移灶可能会提高生存率。在本文中,我们报告了11例患者接受13次重复肝切除的经验。术后死亡率为8%,发病率为23%,出现了两例胆道瘘和一例复发性胸腔积液。首次肝切除后的中位生存时间为23个月,但根据无病间期的长短而有所不同(超过1年和少于1年:分别为49个月和17个月(P<0.05)。我们的结果表明,重复肝切除在技术上是一种安全的手术,可能对选定的患者有益。所有候选患者术前均应仔细评估是否存在肝外疾病。