结直肠癌肝转移的外科治疗

外科手术是治疗结直肠癌肝转移的重要手段。手术切除的适应证已扩展至满足肝内肿瘤能全部切除、切缘阴性、肝脏储备功能足够即可；而手术切除联合局部治疗进一步扩大了手术适应证。转移癌及原发癌一期或二期手术的远期生存率比较，差异无统计学意义。腹腔镜手术治疗结直肠癌肝转移安全可行，疗效确切。围手术期辅助化疗疗效并不明确，新辅助化疗可能不会使所有患者都受益。

Surgical treatment for colorectal liver metastases

Surgical resection is the treatment of choice for patients with colorectal liver metastases. The criteria for he- patic resection of colorectal liver metastases have been extended. Patients who were expected to have complete tumor resection, negative resection margin and adequate remnant liver volume could receive surgical resection. Surgical resection combined with local ablation can expand the resectability of liver metasta- ses. There is no significant difference of long-term survival be- tween simultaneous and staged resection for colorectal and liver tumors. Laparoscopic surgery has been proved as safe and feasi- ble for colorectal liver metastases. The survival benefits of adju- vant chemotherapy during perioperative period is unclear, and neo-adjuvant chemotherapy might not benefit all the patients with colorectal liver metastases.