Bismuth H, Adam R, Navarro F, Castaing D, Engerran L, Abascal A
Hepato-Biliary Surgery and Liver Transplant Unit, Paul Brousse Hospital and Faculty of Medicine Paris Sud, Villejuif, France.
Surg Oncol Clin N Am. 1996 Apr;5(2):353-64.
With the decreasing mortality and morbidity of liver resection in the last 10 years, a more aggressive approach has emerged against liver metastases of colorectal cancer. Repeat liver resection is being performed for patients with isolated liver recurrence following a first hepatectomy. Based on a 2-year experience of 55 repeat hepatic resections performed in 44 patients, the authors observed no operative mortality and a postoperative morbidity of 15% similar to that of first hepatectomies. Five-year survival rate is 44% following second hepatectomy. These results combined with the review of the literature demonstrate that rehapectomy may be performed safely and may provide the only chance of long-term remission in patients presenting with technically resectable liver recurrence in the absence of widespread extrahepatic disease.
在过去10年中，随着肝切除死亡率和发病率的降低，针对结直肠癌肝转移出现了更积极的治疗方法。对于首次肝切除术后出现孤立性肝复发的患者，正在进行再次肝切除。基于对44例患者进行55次再次肝切除的2年经验，作者观察到无手术死亡，术后发病率为15%，与首次肝切除相似。二次肝切除术后5年生存率为44%。这些结果结合文献回顾表明，在没有广泛肝外疾病的情况下，对于出现技术上可切除的肝复发患者，再次肝切除可以安全进行，并且可能是实现长期缓解的唯一机会。
