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Simultaneous colorectal and parenchymal-sparing liver resection for advanced colorectal carcinoma with synchronous liver metastases:Between conventional and mini-invasive approaches

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World Journal of Gastroenterology 2020年第42期26卷 6529-6555页

作者： Emilio De Raffele Mariateresa Mirarchi Dajana Cuicchi Ferdinando Lecce Riccardo Casadei Claudio Ricci saverio selva Francesco Minni Division of Pancreatic Surgery Department of Digestive DiseasesAzienda Ospedaliero-Universitaria di BolognaPoliclinico S.Orsola-Malpighi40138 BolognaItaly Dipartimento Strutturale Chirurgico Ospedale SS Antonio e Margherita15057 Tortona(AL)Italy Surgery of the Alimentary Tract Department of Digestive DiseasesAzienda Ospedaliero-Universitaria di BolognaPoliclinico S.Orsola-Malpighi40138 BolognaItaly Division of Pancreatic Surgery Department of Medical and Surgical Sciences(DIMEC)Alma Mater StudiorumUniversity of Bologna40138 BolognaItaly

The optimal timing of surgery in case of synchronous presentation of colorectal cancer and liver metastases is still under *** approach,with initial colorectal resection followed by liver resection(LR),or even the reverse,liver-first approach in specific situations,is traditionally *** resections,however,represent an appealing strategy,because may have perioperative risks comparable to staged resections in appropriately selected patients,while avoiding a second surgical *** patients with larger or multiple synchronous presentation of colorectal cancer and liver metastases,simultaneous major hepatectomies may determine worse perioperative outcomes,so that parenchymal-sparing LR should represent the most appropriate option whenever ***-invasive colorectal surgery has experienced rapid spread in the last decades,while laparoscopic LR has progressed much slower,and is usually reserved for limited tumours in favourable ***,mini-invasive parenchymal-sparing LR is more complex,especially for larger or multiple tumours in difficult *** remains to be established if simultaneous resections are presently feasible with mini-invasive approaches or if we need further technological advances and surgical expertise,at least for more complex *** review aims to critically analyze the current status and future perspectives of simultaneous resections,and the present role of the available miniinvasive techniques.

关键词： Synchronous colorectal liver metastases Colorectal surgery Liver surgery Simultaneous resection Parenchymal-sparing liver resection Mini-invasive surgery Intraoperative ultrasonography

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