J.Jpn. Surg. Soc.. 107(3): 122-127, 2006

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Feature topic

STAGED SURGERY FOR MULTIPLE BILOBULAR HEPATICMETASTASES FROM COLORECTAL CANCER

Staged surgery is sometimes selected to treat patients with bilobular multiple liver metastases from colorectal cancer, consisting of first-stage and second-stage operations. The first-stage hepatectomy is performed to clear the left lobe of metastases by resection or local ablation therapy. Subsequently, right portal vein embolization is performed to induce atrophy of the right lobe and hypertrophy of the left lobe. Finally, second-stage hepatectomy is planned to resect right lobe metastases. However, high morbidity and mortality rates and poor prognosis are frequent in staged surgery. Improvements such as better preoperative surgical planning and the use of adhesive barriers and antiinfection measures to prevent surgical site infections are necessary.

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