腹腔镜肝切除术与射频消融术治疗小肝细胞癌疗效及对生活质量的影响

摘 要：［目的］ 比较腹腔镜肝切除术与射频消融术治疗小肝细胞癌的疗效及对患者生活质量的影响。［方法］ 收取小肝细胞癌患者79例作为研究对象,根据术式不同将其分为腹腔镜组（41例）和射频消融组（38例）,分别采用腹腔镜肝切除术与射频消融术进行治疗。比较两组患者围手术期指标（手术时间、术中出血量、输血例数及住院时间）、治疗效果、术后疼痛评分、并发症以及生活质量恢复情况。［结果］ 射频消融组手术时间、术中出血量、输血例数及住院时间均显著低于腹腔镜组,差异具有统计学意义（P<0.05）。腹腔镜组总缓解率（85.37%）低于射频消融组（89.47%）,但差异无统计学意义（P>0.05）。射频消融组疼痛VAS评分明显低于腹腔镜组,差异有统计学意义（P<0.05）。两组并发症无统计学差异（P>0.05）。射频消融组生活质量改善率（60.52%）明显高于腹腔镜组（31.71%）,差异有统计学意义（P<0.05）。［结论］ 采用射频消融术治疗小肝细胞癌与腹腔镜肝切除术相比具有更好的临床疗效,利于减轻疼痛并提高患者生活质量。     

射频消融技术在肝肿瘤切除术中的应用

目的探讨复杂肝切除术中辅助使用射频消融技术的可行性。方法回顾性分析2007年3月至2013年2月间收治的行巨大或多发肝肿瘤切除术的32例患者资料,其中14例患者(射频辅助切肝组)术中辅助使用射频消融术,18例患者(常规切肝组)行常规肝脏切除术。比较两组患者手术时间、术中出血量、肝门阻断时间、术后住院时间、术后肝功能和术后并发症。结果射频辅助切肝组患者术中出血量为150~1200ml,中位出血量350ml,常规切肝组术中出血量为350~1500ml,中位出血量750ml,组间比较差异有统计学意义(P<0.001)。射频辅助切肝组肝门阻断时间肝门阻断时间为0~15min,中位时间3min,常规切肝组肝门阻断时间为5~35min,中位时间9.5min,组间比较差异有统计学意义(P<0.001)。两组患者的手术时间、术后住院时间、术后第3天及第7天白蛋白、丙氨酸转氨酶、总胆红素、血小板水平比较,差异无统计学意义(均P>0.05)。两组均无死亡、胆漏、出血、腹腔感染等并发症。结论射频消融辅助的肝切除术安全有效、出血少、肝门阻断时间短,但相比常规手术,费用昂贵且精准性不足可能是制约其临床普及的主要因素。     

射频凝固电极在肝癌切除或消融治疗中的应用

目的评价射频凝固电极消融技术在肝切除术中应用的可行性、安全性及疗效。方法采用射频凝固电极射频消融技术进行肝癌切除手术共16例,其中腹腔镜下射频消融后肝切除术9例,腔镜下射频消融6例（共13个瘤体,平均最大肿瘤直径3．0-4-1．0em）,小切口腹腔镜辅助右肝V、Ⅷ段肝癌切除1例。观察术后并发症情况,肿瘤复发情况。结果16例均顺利完成肝癌切除或消融治疗。未出现严重并发症。肝癌消融灶完全坏死率为92．3％。随访8～20个月（平均14个月）,于术后3、6个月各发现1例肝脏出现新病灶,1例消融部位肿瘤残留。肝癌切除患者未出现新病灶。死亡1例。结论腹腔镜下手术或开腹术中射频凝固电极消融技术在肝癌切除或消融治疗中应用安全可行,效果好。选择远离肝门区肿瘤进行治疗时效果更佳。     

肝、胆、胰、脾

腹腔镜肝癌切除术61例疗效分析;原发性肝癌面临的难点与对策（述评）;结直肠癌术后肝脏尾状叶转移瘤的手术切除（附18例报告）;冷循环射频消融治疗肝尾状叶肿瘤;腹腔镜左半肝切除术28例报告……     

原发性中小肝癌手术与射频消融治疗的疗效分析

目的:比较射频消融(radiofrequency ablation,RFA)治疗与手术切除治疗(surgical resection,SR)对于原发性小肝癌的疗效。方法:2003年1月到2009年6月共收治经甲胎蛋白(AFP)联合影像学(MRI或CT)证实的原发性中小肝癌患者125例:RFA组60例(B超引导下经皮射频消融51例,腹腔镜下射频消融6例,CT定位经皮射频消融3例),SR组65例:采用常规手术切除治疗(肿瘤局部挖出48例,肝段切除12例,肝叶切除5例)。评估并比较两组治疗效果。结果:RFA组和SR组术后第1、2和3年生存率分别为88.33%、71.67%、58.33%和93.85%、80.00%和72.31%,两者的生存曲线采用Kaplan-Meier检验有统计学意义(P=0.043)。RFA组和SR组术后第1、2和3年的肿瘤复发率分别为15.00%、31.67%、56.67%和10.77%、24.62%和36.92%,两组比较,复发率差异有统计学意义(P=0.034)。结论:射频消融治疗虽具有术后恢复快、出血量少、住院日短、花费少等微创特点,但在肿瘤复发率和术后生存率方面不如传统手术切除治疗。     

冷循环射频消融治疗肝脏肿瘤42例报告

探讨冷循环射频消融治疗肝脏肿瘤的可行性和有效性。应用冷循环电极射频消融治疗42例肝脏肿瘤60个结节。37例在局麻超声引导下、2例在腹腔镜辅助下和3例在开腹术中行射频消融，射频消融治疗75点次。治疗后通过CT和MR随访，随访时间2～14个月，肿瘤完全低密度灶者占70%（42／60），增强扫描局部病灶有强化（残留或复发）8．3％（5／60）。初步研究结果提示，冷循环射频消融治疗肝脏肿瘤是有效和安全的。     

手术切除肝脏巨大肿瘤63例经验总结

目的:探讨手术治疗肝脏巨大肿瘤的可行性及疗效。方法:自2000年1月～2005年6月间行手术治疗63例巨大肝脏肿瘤(其中原发性肝癌53例),采用常温下间歇性肝门阻断,阻断时间6～48分钟。结果:本组肝切除术取得较好疗效,原发性肝癌患者的1、3、5年生存率分别为63.4%、36.5%和15.4%,8例出现明显的并发症,仅1例(1.59%)术后20天死于肝功能衰竭。结论:如能掌握好手术适应证和手术技巧,手术治疗肝脏巨大肿瘤是安全和有效的。     

内镜下套扎器联合圈套器在胃底黏膜下微小肿瘤治疗中的应用效果#br#

目的探讨内镜下套扎器联合圈套器在胃底黏膜下微小肿瘤治疗中的应用效果。方法 选取2016年3月至2020年12月于梅州市人民医院检查并择期行手术治疗的93例胃底黏膜下微小肿瘤患者，按手术方式的不同分为观察组（36例）与对照组（57例）。观察组采用套扎器联合圈套器辅助的内镜下黏膜切除术治疗，对照组采用常规内镜下黏膜剥离术治疗，术后均给予质子泵抑制剂（PPI）、抗生素、抑酸等常规治疗，并于术后3个月复查胃镜。记录两组患者的手术时间、术中出血量及术中穿孔情况，比较两组肿瘤完整切除率、切缘阳性率及术后并发症发生率，评估两组术后创面愈合情况。结果观察组手术时间较对照组更短[（3068±574）min vs. （4279±731）min]，术中出血量较对照组更少[（211±054）ml vs. （365±067）ml]，差异有统计学意义（P＜005），两组术中穿孔率、肿瘤完整切除率、切缘阳性率差异均无统计学意义（P＞005）。术后3个月复查胃镜，观察组创面愈合良好，见白色瘢痕，对照组溃疡1例，钛夹残留2例，其余患者创面瘢痕愈合良好，随访期间两组均无复发。观察组术后并发症发生率较对照组降低（1667% vs. 3684%，P＜005）。结论内镜下套扎器联合圈套器应用于胃底黏膜下微小肿瘤的治疗简化了手术程序，缩短了手术时间和患者住院时间，肿瘤完全切除率高，安全性佳。     

超声引导下经皮射频消融与腹腔镜手术治疗原发性肝癌的疗效及安全性比较

目的 比较超声引导下经皮射频消融与腹腔镜手术治疗原发性肝癌的疗效及安全性.方法 根据治疗方式将80例原发性肝癌患者分为消融组(n=42)和腹腔镜组(n=38),其中消融组患者接受超声引导下经皮射频消融治疗,腹腔镜组患者接受腹腔镜肝切除术治疗.比较两组患者的一般手术指标、肝功能指标、根治及复发情况、并发症发生情况及术后3年生存情况.结果 消融组患者手术时间、手术住院时间均明显短于腹腔镜组患者,术中出血量、医疗费用均明显低于腹腔镜组患者,差异均有统计学意义(P﹤0.01).两组患者术后肝功能指标、根治率和复发率、术后1～3年生存率比较,差异均无统计学意义(P﹥0.05).消融组患者并发症总发生率为7.14％,低于腹腔镜组患者的26.32％,差异有统计学意义(P﹤0.05).结论 超声引导下经皮射频消融治疗原发性肝癌的疗效与腹腔镜手术的疗效相似,但射频消融术更加微创,有助于患者术后恢复,还可节省医疗费用.     

区域性肝血流阻断在肝癌切除术中的应用与近期效果

目的:探讨区域性肝血流阻断在肝癌切除术中的应用价值。方法:回顾性分析69例肝癌切除术患者的临床资料,其中行区域性肝血流阻断肝癌切除38例,全肝入肝血流阻断（Pringle法）肝癌切除31例,比较两组患者的手术时间、术中出血量、术中输血率、术后并发症发生率、谷草转氨酶（AST）、引流量、排气时间、术后住院时间和标本切缘满意率。结果:与Pringle法肝癌切除组比较,区域性肝血流阻断肝癌切除组患者术中出血量、术后引流量、术后AST水平及并发症发生率均明显降低（均P<0.05）;标本切缘满意率显著提高（P<0.05）。而术中输血率、术后排气时间、术后住院时间比较,两组间差异无统计学差异（均P>0.05）。结论:用区域性肝血流阻断法行肝癌切除术,具有术中出血少,手术打击小,肿瘤切缘满意率高,术后渗出和并发症少等优点。     

Microwave-assisted liver resection vs. clamp crushing liver resection in cirrhosis patients with hepatocellular carcinoma

Purpose: This study aimed to evaluate the safety and effectiveness of microwave-ablation-assisted liver resection (MW-LR) and clamp crushing liver resection (CC-LR) in cirrhotic patients with hepatocellular carcinoma (HCC).

Materials and methods: From July 2005 to January 2015, cirrhotic HCC patients who underwent CC-LR (n?=?191) or MW-LR (n?=?112) were retrospectively analysed. We compared morbidity, mortality, disease-free survival (DFS) time and overall survival time between the CC-LR and MW-LR groups.

Results: The blood loss volume was significantly higher in the CC-LR group (mean of 752?ml) than that in the MW-LR group (mean of 253?ml, p?p?=?0.029). The 30-day mortality rate (1.5% vs. 0.8%) and postoperative complication rate (32.9% vs. 25.0%) were both similar between the CC-LR and MW-LR groups. MW-LR provided a survival benefit over CC-LR at 1, 3 and 5 years in the entire population (93.5% vs. 87.0%, 77.0% vs. 62.5% and 50.0% vs. 36.5%, respectively; p?=?0.003). In a subgroup analysis, MW-LR provided a survival benefit over CC-LR for Barcelona Clinic Liver Cancer stage A (BCLC-A) HCC (p?=?0.026) and stage B (BCLC-B) HCC (p?=?0.035) patients and provided DFS benefits for BCLC-A HCC patients (p?=?0.036).

Conclusions: MW-LR is a safe and feasible procedure for HCC patients with a cirrhotic liver history.     

Radiofrequency-assisted liver resection

BACKGROUND: Surgical resection remains the treatment of choice for primary, secondary liver cancer and a number of benign liver lesions. Complications are mainly related to blood loss. Radiofrequency-assisted liver resection (RF-LR) has been proposed in order to achieve minimal blood loss during parenchymal transection. PATIENTS AND METHODS: Between May 2005 and April 2007, 46 consecutive patients with various hepatic lesions underwent RF-LR using Radionics, Cool-Tip System. There were 28 men and 18 women with median age 65 years (range 54-76 years). Twelve major and 34 minor hepatectomies were performed for various diseases: hepatocellular carcinoma (n=19), metastatic carcinoma (n=23), focal nodal hyperplasia (n=2) and intrahepatic cholangiocarcinoma (ICC) (n=2). Hepatic inflow occlusion was not used. RESULTS: No perioperative death was documented. Median blood loss was 100ml (range 30-300cm(3)). Blood transfusion was required postoperatively in one patient. Median transection time was 35min (15-60min). Three patients developed biliary fistulas, four patients pleural effusions, one patient hyperbilirubinemia, two pneumonia and four wound infection. The median postoperative hospital stay was 6 days (range 4-10 days). In a median 12 month follow-up (range 3-24 months), four patients with colorectal metastases (CRM) and one patient with ICC developed recurrence. CONCLUSIONS: Cool-Tip RF device provides a unique, simple and safe method of bloodless liver resections and is indicated in cirrhotic patients with challenging hepatectomies (segment VIII, central resections).     

Combined colon and hepatic resection for synchronous colorectal liver metastases

BACKGROUND AND OBJECTIVES: The surgical strategy for the treatment of resectable synchronous hepatic metastases of colorectal cancer remains controversial. This study was performed to assess the outcome of combined resection of colorectal cancer and liver metastases. METHODS: The perioperative data, morbidity, and survival of the patients who underwent combined colon and liver resections for synchronous colorectal liver metastases from 1988 to 1999 were compared to the parameters of the patients who underwent colon resection followed by resection of liver metastases in a staged setting. RESULTS: 198 hepatic resections were performed, of which 112 procedures in 103 patients were done for metastatic colorectal carcinoma. Twenty six patients (25%) had combined hepatic and colon resection and were compared to 86 patients with metachronous metastases who underwent colon and hepatic resection in the staging setting. Postoperative morbidity was 27 and 35%, respectively. There was no hospital mortality in the combined group vs. 2.3% in the staged group. Blood loss, intensive care unit (ICU) stay and length of postoperative stay (LOS) were similar in both groups. The 5 years cumulative survival of the group after combined surgery was 28% vs. 27% of the group after isolated hepatic resections (P = 0.21). CONCLUSION: Combined colon and hepatic resection is a safe and efficient procedure for the treatment of synchronous colorectal liver metastases. It can be performed with acceptable morbidity and no perioperative mortality. The survival after combined procedure is comparable to the one achieved after staged procedure of colon resection followed by liver resection.     

术前肝功能储备预测肝癌手术患者预后价值的倾向性匹配研究

目的:运用倾向性评分匹配法(PSM)探讨术前肝功能储备对肝癌术后生存情况的预测价值。方法:绘制术前肝功能储备预测肝癌患者术后生存价值的ROC曲线,获得术前肝功能储备的最佳诊断截点,根据术前肝功能储备的最佳诊断截点将所有患者分为两组,运用1∶1倾向性匹配评分(PSM)法将Logistic模型估计的倾向性评分相近的两组患者进行配对,检验匹配前后两组间各临床病理指标的均衡性,Kaplan-Meier生存 分析比较匹配后两组患者术后无瘤生存率和总生存率,Cox回归模型进行敏感性分析,验证匹配后术前肝功能储备对肝癌术后生存情况的预测价值。结果:研究共纳入207例肝癌患者,平均年龄(54.1±15.4)岁,其中男性132例(63.8%),女性75例(36.2%),术后1年、3年、5年无瘤生存率和总生存率分别为75.3%、45.9%、37.1%和84.7%、57.6%、48.2%,术前肝功能储备预测肝癌患者术后生存价值的AUC为0.821(95%CI:0.763～0.894),最佳诊断截点为14.13,相应的灵敏度和特异度分别为84.5%和81.2%,根据术前肝储备功能的最佳诊断截点,将患者分别分为肝储备功能良好组134例(64.7%)和肝储备功能不全组73例(35.3%),匹配后肝储备功能不全组患者术后出血和肝衰竭的发生率明显高于肝功能储备良好组,Kaplan-Meier生存分析显示,肝储备功能良好组术后1年、3年、5年总生存率明显高于肝储备功能不全组(91.4%、82.5%、74.7% vs 83.2%、52.7%、43.6%,P＜0.05),Cox多因素分析显示,肝癌患者术前肝储备功能每降低1%,患者术后5年内死亡的风险增加1.124倍(OR:2.124,95%CI:1.278～2.875,P=0.028)。结论:术前肝储备功能可用于准确评估肝癌患者术后肝衰风险以及远期总生存率。     

肝胰病灶同步切除治疗胰腺癌肝转移的安全性及对预后的影响

目的:探讨肝胰病灶同步切除治疗胰腺癌肝转移（pancreatic cancer with liver metastases，PCLM）的安全性及对预后的影响。方法:回顾性分析盛京医院2012年1月至2017年12月收治的27例行肝胰病灶同步切除的PCLM患者的临床资料，分析影响预后的相关因素。并分别通过与27例行胰腺根治手术的无肝转移胰腺癌患者及20例行姑息性旁路手术的PCLM患者比较，评估肝胰病灶同步切除的意义。结果:对27例肝胰病灶同步切除的胰腺癌肝转移患者临床特征及治疗方式进行多因素分析，可能影响预后的变量为:肝转移灶个数、γ-谷酰胺转肽酶（GGT）。接受肝胰病灶同步切除的PCLM患者的中位生存期低于单纯行胰腺切除的无肝转移胰腺癌患者［(5.3±0.5)个月vs (12.1±0.3)个月，P<0.001］，与行姑息性旁路手术的PCLM患者相比，差异无统计学意义［(5.3±0.5)个月vs (4.1±0.1)个月，P=0.932］。肝胰病灶同步切除组的手术时间、术后感染发生率多于单纯胰腺切除组，术中出血量、术后并发症总体发生率、术后住院天数，两组差异无统计学意义；肝胰病灶同步切除组的手术时间、术中出血量、术后并发症总体发生率、术后住院天数均多于姑息性旁路手术组。结论:肝胰病灶同步切除治疗PCLM可以相对安全的进行，个别患者可能从中受益，其中GGT无明显升高的孤立性PCLM患者，预后相对较好。但现阶段对预后改善有限，且并不明显优于姑息性旁路手术，不能明显提高整体生存率。     

胃癌合并肝硬化门脉高压症患者行根治术后出现并发症的危险因素及预后分析

目的:探讨胃癌合并肝硬化门脉高压症患者行根治术后出现并发症的危险因素及预后特点。方法:收集2000年1月至2012年1月我院收治的123例行根治性切除术的胃癌合并肝硬化门脉高压症患者的临床资料。统计分析可能与术后并发症相关的危险因素，以电话或门诊复查等方式进行随访，分析术后并发症与患者长期生存的关系。结果:123例患者无一例围术期死亡。术后共78例（63.4%）患者出现了并发症，其中以腹水最为常见，共36例，其次分别为肺部感染22例、出血11例、切口感染10例、术后肝肾功能障碍9例、膈下感染7例。单因素分析结果显示，患者术后并发症的发生与肿瘤直径、上消化道出血史、Child分级、血清白蛋白、血小板、血红蛋白、术中出血量相关（P＜0.05），但与患者性别、年龄、肿瘤部位、分期、肝硬化病因、手术方式、手术时间无关（P＞0.05）。Logstic多因素分析发现，仅有Child分级、血清白蛋白、术中出血量是影响患者术后并发症发生的独立性危险因素（P＜0.05）。截至随访日期，并发症组78例患者，死亡42例，5年生存率为46.1%（36/78）；无并发症45例患者，死亡15例，5年生存率为66.7%（30/45）。两组患者总体生存率之间差异有统计学意义（P=0.023）。结论:对于胃癌合并肝硬化的患者，术后出现并发症是远期预后不良的重要信号。Child分级、血清白蛋白、术中出血量是影响术后并发症发生的最主要因素。术前积极调整Child分级，补充血清白蛋白，术中遵循减伤原则，控制出血，或能有效减少术后并发症发生。     

Precoagulation with microwave ablation for hepatic parenchymal transection during liver partial resection

Purpose: To evaluate the feasibility of precoagulation with microwave ablation (MWA) for hepatic parenchymal transection during liver partial resection.

Methods: A total of 66 eligible patients were enrolled in this double-blind, randomized, controlled study. Patients were randomized to receive either the traditional clamp-crushing method (Control group) or the MWA precoagulation method (MWA group) for hepatic parenchymal transection during liver partial resection. The operative time, hepatic portal occlusion time, intraoperative blood loss and transfusion, postoperative complications and recovery outcomes were compared.

Results: Compared to the Control group, the MWA group had significantly less intraoperative blood loss. Fewer red blood cell transfusions were observed in the MWA group but without statistical significance. The MWA group showed significantly higher serum alanine aminotransferase and aspartate aminotransferase levels at day 1 postoperatively, but no differences between the MWA and Control groups were found at days 3 and 7. There were no significant differences in terms of operative time, hepatic portal occlusion time, postoperative total bilirubin levels, human albumin solution consumption or length of hospital stay. Postoperative complications such as impaired renal function, pyrexia, admission to ICU, abscess, biliary leakage, intrahepatic and distant tumor recurrence and in-hospital mortality were comparable between the two groups.

Conclusion: Precoagulation with MWA reduced intraoperative blood loss with similar postoperative complications, providing a safe, effective, novel alternative for hepatic parenchymal transection during liver partial resection. Additional results from larger series are recommended to confirm these findings.     

ALPPS术在尾状叶肝癌中的应用(附1例报道)

目的:报道ALPPS成功治疗尾状叶肝癌1例，分析ALPPS对于尾状叶肝癌的可行性及安全性。方法:患者，男，58岁，66 kg，因“体检发现肝占位20天”入院，肝脏超声示肝右叶占位性病变，初步诊断:尾状叶肝癌。患者尾状叶肝癌累及门静脉右支、肝中静脉、肝右静脉、下腔静脉肝后段，需行右半肝及尾状叶切除。经术前评估患者剩余肝脏体积不能满足切除要求，遂行ALPPS手术。结果:第一步手术时间210 min，术中出血量200 ml，术中未输血，术后无严重并发症。术后第7天左半肝体积增长至547 ml，占标准肝脏体积的46.3%，术后第14天行第二步手术。第二步手术时间180 min，术中出血量400 ml，输注红细胞3 U，血浆800 ml。Clavien-Dino并发症分级Ⅱ级，主要并发症为胆漏，予以充分引流后好转。患者术后康复良好，随访13个月，肿瘤无复发。结论:ALPPS为尾状叶肝癌患者提供了新的手术方案参考。     

炎症预后指数对经导管肝动脉化疗栓塞术治疗肝癌疗效的评估价值

目的:探讨以血清中白蛋白(ALB)、淋巴细胞计数、C反应蛋白(CRP)、中性粒细胞与淋巴细胞比率(NLR)为基础的炎症预后指数(IPI)在经导管肝动脉化疗栓塞术（TACE）治疗肝癌中的疗效以及预后评估价值。方法:回顾分析2014年01月至2016年12月在我院接受肝动脉化疗栓塞术治疗的286例肝癌患者的临床资料,计算患者IPI。采用受试者工作特征（ROC）曲线计算IPI截断值,并采用单因素和多因素COX回归分析探讨影响患者术后生存情况的独立影响因素。结果:随访期间24例患者失访,以IPI=14.56为临界值,将随访有效的262例肝癌患者分为高IPI组（n=154）和低IPI组(n=108);临床病理资料分析结果显示,病灶数量、肿瘤最大径、是否存在门脉癌栓、AFP水平、TNM分级对肝癌患者的IPI表达水平具有显著影响（P＜0.05）;随访期间共死亡68例,中位生存时间为9个月;其中高IPI组死亡53例,中位生存时间为6（1~28）个月;低IPI组死亡15例,中位生存时间为13（4~36）个月,两组患者中位生存时间差异具有统计学意义（P=0.015);多因素COX回归分析结果显示肿瘤IPI>14.56（OR=5.689,95%CI 1.589~13.254）是影响肝癌患者预后的独立危险因素。结论:NLR、CRP、ALB、IPI均是影响肝癌患者TACE术后预后的独立危险因素,以NLR、CRP、ALB为基础的IPI对于预测肝癌患者手术疗效和预后生存情况具有重要价值。     

Result of liver resection as treatment for metastases from noncolorectal cancer

BACKGROUND AND OBJECTIVES: While liver resection for metastatic disease from colorectal cancer extends survival in selected patients, the efficacy of hepatectomy for metastases from other malignancies has not been defined. METHODS: Between 1988 and 1998, 20 hepatic resections were performed in 18 patients (2 underwent a double resection due to recurrence) as treatment of noncolorectal metastases. One-, 2-, and 5-year overall and disease-related actuarial survival rates were calculated. RESULTS: No intraoperative or early postoperative deaths were reported. Seven minor (30%) and 1 major (5%) postoperative complications occurred; mean blood loss was 401 +/- 324 ml. In 25% of patients, intra- or postoperative blood transfusion was needed. The mean postoperative hospital stay was 13. 2 days (range 9-23). The overall actuarial survival rate was 54% at 1 year, 42% at 2 years, and 21% at 5 years (mean 38 +/- 11 months). Survival is related to the primary tumor nature. CONCLUSIONS: Hepatic resection for metastases from noncolorectal carcinoma is safe and feasible, with a relatively low incidence of intra- or postoperative complications and a short hospital stay. Although it achieves good results in terms of survival in patients suffering from neuroendocrine metastases, it could also have a cytoreductive effect for other tumors.