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Resection for multiple metastatic liver tumors after portal embolization
S Kawasaki1, M Makuuchi, T Kakazu
1First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Surgery
|June 1, 1994
Summary
Extensive liver resection following portal vein embolization is a safe and effective treatment for patients with multiple colorectal cancer liver metastases. This approach offers long-term cancer-free survival for eligible patients.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Gastrointestinal oncology
Background:
- Colorectal cancer frequently metastasizes to the liver, presenting a surgical challenge.
- Bilateral multiple liver metastases (3-12 lesions) often preclude curative resection.
- Extensive liver resection after portal vein embolization is an option for selected patients.
Purpose of the Study:
- To evaluate the safety and efficacy of extensive liver resection after portal vein embolization.
- To assess outcomes in patients with multiple bilateral liver metastases from colorectal cancer.
Main Methods:
- Portal vein embolization of the right portal branch was performed prior to hepatic resection.
- Intraoperative ultrasonography was used to identify and locate all metastases.
- Extended right lobectomy with or without additional wedge resections was performed.
Main Results:
- All five patients experienced an uneventful postoperative recovery without significant complications or liver dysfunction.
- Four out of five patients remained cancer-free for 36-74 months post-hepatectomy.
- One patient died of recurrence 28 months after surgery.
Conclusions:
- Extensive liver resection is feasible for colorectal cancer with multiple bilateral liver metastases when guided by intraoperative ultrasonography.
- Portal vein embolization enhances the safety of major hepatectomy, particularly for extensive disease requiring combined resections.
- Careful patient selection and thorough surgical assessment are crucial for successful outcomes.