[Surgical treatment for colorectal carcinoma combined with liver cirrhosis].
Surgical treatment for colorectal carcinoma associated with liver cirrhosis is discussed. Resection of this carcinoma is considered safe for patients whose liver function belongs to clinical stage I, II or Grade A, B of Child-Pugh classification or KICG more than 0.06/min. When hepatocellular carcinoma (HCC) is associated and the remnant liver function is feasible, hepatic resection should be undertaken at a favorable opportunity. When risky esophageal varices are present, endoscopic variceal ligation (EVL) or sclerotherapy (EIS) should be performed preoperatively. Lymph node dissection should be restricted to D1 or D2. In the postoperative phase, attention should be paid to maintaining liver function and hepatic circulation. Dobutamine or dopamine is useful for increasing hepatic blood flow. Fresh frozen plasma or platelet transfusion is used when needed.
Nonami
T
T
Department of Surgery II, Nagoya University School of Medicine, Japan.
Hirai
A
A
Takagi
H
H
D015179:Colorectal Neoplasms / Q000601:surgery*; D004932:Esophageal and Gastric Varices / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications; D011182:Postoperative Care; D011300:Preoperative Care