[Operative-technical special features of the left lobectomy in colorectal cancer liver metastases]

The indications of the liver resection are the primary and secondary malignant neoplasms of the liver, the benign liver tumors and some inflammatory diseases. Approximately 10-30% of the patients with colorectal cancer liver metastases are suitable to a curative liver resection. The aim of the study is to presenti of the operative-technical special features of the anatomical left lobectomy of patients with colorectal cancer liver metastases. In the course of 24 months we carried out 9 anatomical left liver resections. The indications of the operation of eight of them were solitary metastases, which had appeared after an operation on colorectal cancer and at one of them the resection was performed due to an angiosarcoma of the liver. The operative blood loss was in the order of 100 ml. The operative mortality and postoperative morbidity were 0%. The anatomical knowledge of the Rex's recessus is a key of utmost importance for the performance of a left lobectomy. The Rex's recessus is a physiological enlargement of the left branch of v.porta in the region of the clamping of ligamentum teres. The liver resection highly improves the prognosis on the following conditions: a radical treatment of the primary tumor, an absence of local recurrence, an absence of an extrahepatic incidence of the primary tumor and a preservation of a sufficient capacity of the liver.