Current status of associating liver partition and portal vein ligation for staged hepatectomy in treatment of liver metastasis of colorectal cancer
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摘要: 目前,结直肠癌肝转移的最佳治疗策略仍是根治性手术切除,而对于巨大肿瘤或者多发肿瘤患者,常常面临肝切除术后残余肝脏体积不足的问题,容易出现术后肝衰竭等严重并发症。联合肝脏离断和门静脉结扎二步肝切除术(ALPPS)是一种新颖的二步肝切除术,可使残余肝在一期术后快速增生,增加肝脏肿瘤的可切除性,降低术后肝衰竭的风险。虽然ALPPS可实现肿瘤R0切除,延长患者生存期。但因其较高的术后并发症率和病死率饱受争议,结合国内外相关研究,对ALPPS在结直肠癌肝转移中的应用现状及临床价值进行阐述。Abstract: At present,radical resection remains the best treatment strategy for liver metastasis of colorectal cancer,and patients with large or multiple tumors often face the problem of insufficient residual liver volume after hepatectomy,which may lead to serious complications including liver failure after surgery. Associating liver partition and portal vein ligation for staged hepatectomy( ALPPS) is a novel two-step hepatectomy that allows rapid proliferation of the residual liver after primary surgery and can improve the resectability of liver tumors and reduce the risk of postoperative liver failure. Although ALPPS can achieve R0 resection or tumors and prolong patients' survival time,there are still controversies over its application due to high incidence rates of complications and mortality rate. With reference to related studies in China and foreign countries,this article reviews the current application status and clinical value of ALPPS in liver metastasis of colorectal cancer.
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Key words:
- colorectal neoplasms /
- neoplasm metastasis /
- hepatectomy
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