外科治疗同时性结直肠癌肝转移的病人选择  

Preoperative selection of patients with synchronous colorectal carcinoma liver metastasis for hepatic resection

作　　者：吴钢[1] 蔡端[1] 

机构地区：[1]复旦大学附属华山医院普外科,上海200040

出　　处：《上海医药》2017年第9期45-49,56,共6页Shanghai Medical & Pharmaceutical Journal

摘　　要：结直肠癌肝转移(CRLM)的手术治疗可以使经选择的病人受益,并明显改善其生存。但是,只有10%~20%的CRLM为可切除的肝转移,因而筛选适合手术治疗的病人至关重要。影像学技术可用于判别病变的特性,并为手术提供依据。满足手术切除的同时性CRLM,要求根治性切除原发病灶和R0切除已知的全部肝转移灶,同时保持足够的预期剩余肝脏(FLR)。有限的、可切除的肝外转移不再被认为是CRLM病人的手术禁忌。我们对同时性结直肠癌肝转移术前病人的选择,围手术期需考虑的相关因素等进行综述。Selected patients of colorectal liver metastases （CRLM） can be benefited from hepatectomy and its survival rate can be significantly improved. Unfortunately, only 10% to 20% of CRLM patients are candidates for resection, thus preoperative selection of patients for surgical treatment is essential. The imaging technique can be used to judge the characteristics of the lesions and provide the basis for the operation. To meet the surgical resection of the simultaneous CRLM, a radical resection of the primary lesion and R0 resection of all known liver metastases are required, while the future liver remnant （FLR） is a crucial factor in patient selection. The presence of limited and resectable extrahepatic metastases is no longer a surgical contraindication in patients with CRLM. In this review, we explore the preoperative selection of patients with colorectal liver metastases for hepatectomy and the related factors to be considered before the operation.

关 键 词：结直肠癌肝转移 肝切除术 术前选择 

分 类 号：R735.34[医药卫生—肿瘤]