[Evaluation of 242 laparotomies for hepatic metastasis performed at the Institut Gustave Roussy over 5 years].
Two hundred and forty two laparotomies for single or multiple isolated liver metastases (LM) have been performed in 5 years. One hundred and seventy three were performed for LM from colo-rectal cancers and after abdominal exploration it has been carried out 46 hepatectomies, 92 implantations of catheter for intra-arterial hepatic chemotherapy (IAHC) and 35 abstentions. Sixty nine were performed for LM from miscellaneous origins and it has been carried out 32 hepatectomies, 18 implantations of catheter for IAHC and 19 abstentions. The main conclusions of this study are: 1) every preoperatively estimated unresectable LM has never been resectable at abdominal exploration. 2) When it was anticipated to perform an hepatectomy, it was possible to do it only in two-third of the cases, the main reason of non resectable LM was intra or extra hepatic diffusion. 3) When the LM has been preoperatively estimated as un-resectable, the metastatic disease was isolated in the liver in two third of the cases and it was almost always technically possible to place an arterial catheter (108 instances in 110 cases). 4) In 3% of the cases, pre-operative images of LM have not been confirmed at surgery and the diagnosis has been made on biopsies with frozen sections which, must always preceded local hepatic treatment.
Elias
D
D
Service de Chirurgie Digestive Carcinologique, Institut Gustave-Roussy, Villejuif.
Lasser
P
P
Bognel
C
C
Leclere
J
J
Rougier
P
P
D000328:Adult; D002408:Catheters, Indwelling; D015179:Colorectal Neoplasms; D004359:Drug Therapy, Combination / Q000379:methods; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007813:Laparotomy; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008297:Male
Bilan de 242 laparotomies pour métastases hépatiques pratiquées en 5 ans à l'Institut Gustave-Roussy.