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Repeated liver resection for recurrent metastases from colorectal cancer. | LitMetric

AI Article Synopsis

  • Repeat liver surgery is an effective treatment for patients with recurrent colorectal liver metastases, offering a chance for increased survival without major surgical risks.
  • A study involving 19 patients found that secondary liver resections had no perioperative mortality, though there were slight increases in surgery time and blood loss compared to the first surgery.
  • The results support repeated hepatic resections as safe and beneficial for selected patients, indicating that a higher number of resections can be advantageous when curative options are available.

Article Abstract

Background/aims: Repeat hepatectomy is the most effective treatment for recurrent colorectal liver metastases. We aim to assess how repeated liver resections increase survival, without unacceptable surgical risk.

Methodology: Between December 1992 and December 1998, among 19 patients, 5 underwent secondary resection of recurrent metastatic disease. Following the primary liver surgery, three patients had systemic chemotherapy with 5-fluorouracil and two locoregional chemotherapy via Port-a-cath in the gastroduodenal artery. We evaluated survival and we compared time of surgery, duration of Pringle maneuver, blood losses and postoperative stay in the hospital between first and second liver surgery.

Results: Perioperative mortality at second liver resection was nil; morbidity minor; mean duration of surgery 320 vs. 260 min; Pringle maneuver 35 vs. 25 min; blood losses 1300 vs. 650 mL; postoperative stay 12.6 vs. 11.5 days. Mean total survival from time of colon resection was 50 months. As an interesting secondary finding, we observed prolonged inhibition of liver regeneration following treatment with Methotrexate.

Conclusions: Repeated hepatic resection is a safe procedure for selected patients. Surgical risk is slightly increased, but the risk/benefit ratio is definitely in favor of as many repeated resections as needed, whenever there is a chance of curative surgery.

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