One-Stage Hepatectomy Following Portal Vein Embolization for Colorectal Liver Metastasis

被引:19
作者
Yamashita, Suguru [1 ]
Hasegawa, Kiyoshi [1 ]
Takahashi, Michiro [1 ]
Inoue, Yosuke [1 ]
Sakamoto, Yoshihiro [1 ]
Aoki, Taku [1 ]
Sugawara, Yasuhiko [1 ]
Kokudo, Norihiro [1 ]
机构
[1] Univ Tokyo, Grad Sch Med, Dept Surg, Hepatobiliary Pancreat Surg Div,Bunkyo Ku, Tokyo 1138655, Japan
关键词
LONG-TERM SURVIVAL; HEPATOCELLULAR-CARCINOMA; RESECTION; IMPACT; REGENERATION; RECURRENCE; OCCLUSION; SURGERY; COHORT; VOLUME;
D O I
10.1007/s00268-012-1861-0
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Although portal vein embolization (PVE) has been applied for surgical resection of colorectal liver metastases (CLM), the clinical usefulness of liver surgery following PVE for CLM remains unknown. Methods A total of 115 patients were evaluated retrospectively. Among them, 49 underwent one-stage hepatectomy following PVE (PVE group). The remaining 66 patients underwent at least hemihepatectomy without PVE (non-PVE group). This analysis compared the short-and long-term outcomes between the PVE and non-PVE groups. Results There were no deaths in either group. Using the Clavien-Dindo classification, the rates of postoperative morbidity >= grade 1 were 34.7 % in the PVE group and 25.0 % in the non-PVE group (p = 0.26). The 3-year overall survival rates were 54.6 and 64.5 % in the PVE and non-PVE groups, respectively (p = 0.89). The multivariate analysis the variable performance/nonperformance of PVE was not detected as an independent predictor of poor survival. Conclusions Our one-stage hepatectomy policy of using PVE provides acceptable morbidity and favorable long-term outcomes.
引用
收藏
页码:622 / 628
页数:7
相关论文
共 30 条
[1]   Sequential preoperative arterial and portal venous embolizations in patients with hepatocellular carcinoma [J].
Aoki, T ;
Imamura, H ;
Hasegawa, K ;
Matsukura, A ;
Sano, K ;
Sugawara, Y ;
Kokudo, N ;
Makuuchi, M .
ARCHIVES OF SURGERY, 2004, 139 (07) :766-774
[2]   Usefulness of Contrast-Enhanced Intraoperative Ultrasound Using Sonazoid in Patients With Hepatocellular Carcinoma [J].
Arita, Junichi ;
Takahashi, Michiro ;
Hata, Shojiro ;
Shindoh, Junichi ;
Beck, Yoshifumi ;
Sugawara, Yasuhiko ;
Hasegawa, Kiyoshi ;
Kokudo, Norihiro .
ANNALS OF SURGERY, 2011, 254 (06) :992-999
[3]   Resection of nonresectable liver metastases from colorectal cancer after percutaneous portal vein embolization [J].
Azoulay, D ;
Castaing, D ;
Smail, A ;
Adam, R ;
Cailliez, V ;
Laurent, A ;
Lemoine, A ;
Bismuth, H .
ANNALS OF SURGERY, 2000, 231 (04) :480-486
[4]  
Chiappa AC, 2004, HEPATO-GASTROENTEROL, V51, P1439
[5]   Combined portal vein embolization and neoadjuvant chemotherapy as a treatment strategy for resectable hepatic colorectal metastases [J].
Covey, Anne M. ;
Brown, Karen T. ;
Jarnagin, William R. ;
Brody, Lynn A. ;
Schwartz, Lawrence ;
Tuorto, Scott ;
Sofocleous, Constantinos T. ;
D'Angelica, Michael ;
Getrajdman, George I. ;
DeMatteo, Ronald ;
Kemeny, Nancy E. ;
Fong, Yuman .
ANNALS OF SURGERY, 2008, 247 (03) :451-455
[6]  
Detroz B, 1994, Cancer Treat Res, V69, P241
[7]   Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].
Dindo, D ;
Demartines, N ;
Clavien, PA .
ANNALS OF SURGERY, 2004, 240 (02) :205-213
[8]   During liver regeneration following right portal embolization the growth rate of liver metastases is more rapid than that of the liver parenchyma [J].
Elias, D ;
de Baere, T ;
Roche, A ;
Ducreux, M ;
Leclere, J ;
Lasser, P .
BRITISH JOURNAL OF SURGERY, 1999, 86 (06) :784-788
[9]   Preoperative selective portal vein embolization before hepatectomy for liver metastases:: Long-term results and impact on survival [J].
Elias, D ;
Ouellet, JF ;
de Baère, T ;
Lasser, P ;
Roche, A .
SURGERY, 2002, 131 (03) :294-299
[10]   MEASUREMENT OF LIVER AND SPLEEN VOLUME BY COMPUTED-TOMOGRAPHY - ASSESSMENT OF REPRODUCIBILITY AND CHANGES FOUND FOLLOWING A SELECTIVE DISTAL SPLENORENAL SHUNT [J].
HENDERSON, JM ;
HEYMSFIELD, SB ;
HOROWITZ, J ;
KUTNER, MH .
RADIOLOGY, 1981, 141 (02) :525-527