结直肠癌肝转移同期肝切除的原则剖析

Analysis of the principles of simultaneous liver resection for colorectal liver metastasis

结直肠癌(CRC)是常见的消化系统恶性肿瘤,其发病率及病死率逐年升高,肝脏是其最常见转移部位。手术治疗是目前治疗结直肠癌肝转移最有效的方法。对于结直肠癌肝转移同期肝切除的手术时机的选择一直是外科医生争论的话题。诸如围手术期化疗或者一些其他新的方法,都可以影响手术时机的选择。随着对结直肠癌肝转移研究的不断深入以及外科手术技巧的不断进步,目前对于同期肝切除的原则仍在很大程度上依赖于新辅助化疗、外科医生对于可切除性的判断以及病人的体质。笔者综述了近些年来对于结直肠癌肝转移同期肝切除的原则剖析,并加以分析。

Colorectal cancer( CRC) is a common malignant tumor of digestive system,and its morbidity and mortality rate is increasing year by year.The liver is the most common site of metastasis and operation therapy is currently the most effective method of metastatic colorectal cancer.The timing of synchronous liver resection has been the subject of debate.Resection strategies include staged resection with colon first approach,staged resection with liver metastases resection first,and simultaneous,with one-stage resection.But factors such as peri-operation period of chemotherapy or some other new methods can affect the timing of the operation.With the continuous progress of the deepening research on colorectal cancer liver metastasis and surgical operation skills for simultaneous liver resection,at present the resection remains largely dependent on the need for neoadjuvant chemotherapy,the surgeons' judgement of resectability,and patients' fitness.This lecture reviews and analyzes the recent pregress for liver metastasis of colorectal cancer simultaneous liver resection principles.