APPLICATION OF A PORTAL VEINLIGATURE FOR PRIMARILY UNRESECTABLE COLORECTAL LIVER METASTASES
Journal Title: Българско списание за обществено здраве (Bulgarian Journal of Public Health) - Year 2017, Vol 0, Issue 3
Abstract
Selected patients with unresectable colorectal liver metastases (CRLM) may become resectable using a two-step approach with portal vein ligature (PVL). The purpose of this study is the evaluation of the results of the two-staged liver resections(LR) using PVL for CRLM in our clinic. Material and methods: During the period 2005-2015 year at the Clinic of hepatobiliary and transplant surgery, MMA-Sofia 290 curative LR for CRL were carried out . In 17 (5.9%) of them is used a two-stage approach with an initial PVL. Results: The reasons for unresectability were multinodularity of the disease in 70.6%, the size of LM (11.8%), poor location (17.6%). Synchronous LM was at 94% of the cases. Simultaneous resection of the primary tumor at the first operation carried out in 58.8% of the cases. During the second operation, at 94% of patients require a major LR. Patients completed a two-staged approach median survival was 40.43 m., with a median of 38.95 m.. Multivariate Cox-analysis found that extended right hemihepatectomy adversely affect survival in patients with two-stage hepatectomy (p = 0.023), increasing the risk over 6 times. Conclusion: The multidisciplinary approach is the most precise form, ensuring proper selection and behavior in patients under consideration for two-stage approach to optimize the therapeutic behavior and clinical outcomes.
Authors and Affiliations
Ivan Vasilevski, Ivelin Takorov, Vasil Mihailov, Tsonka Lukanova, Nikola Vladov
Keywords
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