J.Jpn. Surg. Soc.. 120(2): 165-171, 2019

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Feature topic

COMBINING RESECTION OF MAJOR VESSELS WITH LIVER RESECTION FOR COLORECTAL METASTASES

Recent advances involving surgical techniques and perioperative treatment have expanded the indications for hepatectomy in the treatment of colorectal cancer metastases. Advanced liver metastases occasionally invade major blood vessels such as the major hepatic veins or inferior vena cava, and therefore complete resection of such tumors requires patients to undergo hepatectomy combined with vascular resection and reconstruction. However, no definite consensus on the long-term survival benefits of such challenging procedures has yet been reached. Previous reports sometimes indicated greater surgical risks and poor long-term results when liver resection was applied using ex vivo techniques for metastases invading the major hepatic vein and inferior vena cava. However, according to our treatment results, hepatic resection combined with major blood vessel resection/reconstruction for colorectal liver metastases without ex vivo techniques can be performed with acceptable short-term outcomes and long-term survival comparable to that in patients who undergo conventional hepatectomy. Hepatic resection including major vessel resection/reconstruction for colorectal liver metastases can be performed with acceptable operative risk and broadens the indications for resection in the treatment of advanced colorectal liver metastases.

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