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首页> 外文期刊>Scandinavian journal of gastroenterology. >Impact of increased resection rates and a liver parenchyma sparing strategy on long-term survival after surgery for colorectal liver metastases. A population-based study
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Impact of increased resection rates and a liver parenchyma sparing strategy on long-term survival after surgery for colorectal liver metastases. A population-based study

机译：增强的切除率和肝脏实质备用策略对结直肠肝转放后手术长期存活的影响。 基于人口的研究

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Background and aims: Expanded criteria for resection of colorectal liver metastases (CRLM) have led to a more aggressive surgical attitude. The aim is to evaluate any impact of expanded criteria on perioperative mortality and long-term survival. Materials and methods: A population based study from 2001 to 2015 for patients undergoing surgery for CRLM. The cohort was divided into three 5-year periods. Results: A total of 341 patients underwent resection of CRLM. Relative to the number of colorectal primaries, patients resected for CRLM increased from 82/2520 (3.3%) in 2001-2005 to 151/3071 (4.9%) in 2011-2015 (p = .007). The proportion of patients who underwent formal resections declined from 62% to 21%. There was a substantial increase in resections of synchronous liver metastases, portal vein embolizations, two-stage resections, and the share of octogenarians who underwent resection. The proportion of patients undergoing reresections of new liver recurrences increased from 6% to 24%. The 90-d postoperative mortality for 2001-2005, 2006-2010, and 2011-2015 were 7.9%, 0.8%, and 2.0%, respectively. The median overall survival was 47 months during the two first periods, for the last period not reached. The 5-year overall survival remained at 40% from 2001 to 2010, and estimated at 55.2% from 2011 to 2015. The 5-year disease-free survival was well above 30%. The 5-year overall survival following liver reresection was 52.6%. Conclusion: Postoperative mortality remained at approximately 2%, and the 5-year overall survival at 40% in the first 10 years, but increased to 55% in the last 5 years under study, despite a marked increase in resection rates.
机译：背景和目的：扩展成分肝转放酶（CRLM）的切除标准导致了更具侵略性的手术态度。目的是评估扩大标准对围手术期死亡率和长期存活的任何影响。材料与方法：2001至2015年患者对CRLM手术患者的一项基于群体的研究。队列分为三个5年的时间。结果：共有341名患者接受了CRLM的切除。相对于结肠直肠初始的数量，在2011-2015（P = 0.007）中，Emplized的结肠直肠初级初级患者从82/2520（3.3％）增加到151/3071（4.9％）。经过正式切除术的患者的比例从62％下降到21％。同步肝转移，门静脉栓塞，两阶段切除，两阶段切除以及接受切除切除的份数的分析，存在大幅增加。正在进行新肝脏复发的患者的比例从6％增加到24％。 2001-2005,2006-2010和2011-2015的90-D术后死亡率分别为7.9％，0.8％和2.0％。在两个未达成的时期，中位的整体生存期为47个月。 5年的整体生存率从2001年到2010年持续40％，从2011年到2015年估计为55.2％。5年的疾病生存率远高于30％。肝脏重演后的5年整体存活率为52.6％。结论：术后死亡率约为2％，前10年持续40％的整体生存率为40％，但在过去5年的研究中，尽管切除率显着增加，但在研究下的过去5年增加到55％。

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