title: Repeat liver resection after a hepatic or extended hepatic trisectionectomy for colorectal liver metastasis.
abstract: OBJECTIVE
  A right and left hepatic trisectionectomy and an extended trisectionectomy are the largest liver resections performed for malignancy. This report analyses a series of 23 patients who had at least one repeat resection after a hepatic trisectionectomy for colorectal liver metastasis (CRLM).
  
  
  METHODS
  A retrospective analysis of a single-centre prospective liver resection database from May 1996 to April 2009 was used for patient identification. Full notes, radiology and patient reviews were analysed for a variety of factors with respect to survival.
  
  
  RESULTS
  Twenty-three patients underwent up to 3 repeat hepatic resections after 20 right and 3 left hepatic trisectionectomies. In 18 patients the initial surgery was an extended trisectionectomy. Overall 1-, 3- and 5-year survival rates after a repeat resection were 100%, 46% and 32%, respectively. No factors predictive for survival were identified.
  
  
  CONCLUSIONS
  A repeat resection after a hepatic trisectionectomy for CRLM can offer extended survival and should be considered where appropriate.
authors.affiliation: HPB and Transplant Unit, St. James's University Hospital, Leeds, UK.
authors.forename: Oliver
authors.initials: O
authors.lastname: Ziff
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Rajput
authors.forename: Robert
authors.initials: R
authors.lastname: Adair
authors.forename: Giles J
authors.initials: GJ
authors.lastname: Toogood
authors.forename: K Rajendra
authors.initials: KR
authors.lastname: Prasad
authors.forename: J Peter A
authors.initials: JP
authors.lastname: Lodge
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D004739:England; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D059146:Metastasectomy / Q000009:adverse effects / Q000401:mortality; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: colorectal liver metastases; extended trisectionectomy; hepatectomy; metastasectomy; repeat resection; trisectionectomy