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Two-stage hepatectomy, a 10 years experience.

Giovanni Battista Levi Sandri1, Roberto Santoro2, Giovanni Vennarecci2

  • 1Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Circonvallazione Gianicolense 87, 00151, Rome, Lazio, Italy. gblevisandri@gmail.com.

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Summary
This summary is machine-generated.

Two-stage hepatectomy is a feasible and safe procedure for treating colorectal liver metastases (CLM), offering a potential cure for patients. Careful patient selection is crucial for successful outcomes in this complex surgical approach.

Keywords:
Colorectal metastasesLiver surgeryPortal vein ligationTwo-stage hepatectomy

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Colorectal cancer liver metastases (CLM) are a significant cause of cancer mortality in Europe.
  • Surgical resection is the only curative option for CLM.
  • Two-stage hepatectomy, often combined with portal vein ligation (PVL) or portal vein embolization (PVE), has emerged as a strategy for initially unresectable CLM.

Purpose of the Study:

  • To retrospectively evaluate the safety and feasibility of two-stage hepatectomy for CLM.
  • To assess outcomes including complication rates, procedure completion, and long-term survival.

Main Methods:

  • Retrospective review of 57 patients undergoing two-stage hepatectomy for CLM between 2004 and 2014.
  • Analysis of procedure completion, complications, interval between stages, and overall survival.
  • Inclusion of laparoscopic approach for the first stage in a subset of patients.

Main Results:

  • The procedure was completed in 46 out of 57 patients (80.7%).
  • No postoperative mortality was observed.
  • Complications occurred in 10 patients after the first stage and 18 after the second stage.
  • Median overall survival was 52 months from the first liver surgery.

Conclusions:

  • Two-stage hepatectomy is a feasible and safe approach for selected patients with CLM, with no operative mortality.
  • A laparoscopic approach for the first stage may be beneficial in selected cases.
  • Meticulous patient selection is paramount for optimizing therapeutic outcomes.