摘要
结直肠癌是最常见的恶性肿瘤之一,近一半的结直肠癌病人在病程中发生肝转移(CRLM),肝转移的手术切除率低于30%。手术切除结直肠癌肝转移是唯一的潜在治愈性措施。手术技术的进步提高了肝切除术的安全性,结直肠癌肝转移切除的手术指征在不断扩大,CRC原发灶和肝转移灶一期同步切除或二期切除、联合脏器切除和转移灶的反复切除已广泛开展。近20年来,直肠癌肝转移治疗的策略在不断演变,增加预期剩余肝(FLR)的诸多方法,扩大了手术治疗CRLM的范围,这些方法包括门静脉栓塞/门静脉结扎术(PVE/PVL)、以及联合肝脏劈离和门静脉结扎的二期肝切除术(ALPPS)等,而与传统的大部切除相比保留肝实质(PSH)的肝切除术技术上优势明显。
Colorectal cancer is one of the most common malignancies worldwide. Nearly half of colorectal cancer patients develop colorectal liver metastases （CRLM） during the course of the disease, unforttmately, fewer than 30% are surgically resectable disease. Complete hepatic resection of CRLM has been considered as the only potential curative treatment. Advances in surgical techniques have improved the safety of major liver resection and the indications for liver resection for CRLM have been expanded, which have allowed for more aggressive surgical approaches, such as 2-stage hepatectomy, simultaneous colon and liver resections, multivisceral resections and repeat resections. Treatment strategy for CRLM has been evolved during the last two decades. Several strategies were developed to promote extensive hepatectomy by increasing the future liver remnant （FLR）, such as portal vein embolization （PVE）, 2-stage hepatectomy, and more recently associating liver partition and portal vein ligation for staged hepatectomy （ALPPS）. A growing number of series reveal the technical benefits of parenchymal-sparing hepatectomy （PSH） in comparison with major hepatectomy （MH）.
出处
《上海医药》
CAS
2017年第11期39-44,50,共7页
Shanghai Medical & Pharmaceutical Journal
关键词
结直肠癌肝转移
肝切除术
colorectal cancer liver metastases
hepatectomy
