Современные подходы к хирургическому лечению больных колоректальным раком с метастазами в печени

При метастазах колоректального рака в печени методом выбора является резекция органа, позволяющая увеличить пятилетнюю выживаемость больных до 40–58%. В последние годы пересматривают критерии резектабельности, кандидатами для хирургического лечения считают больных, у которых возможно удаление всех метастазов с отрицательными границами резекции и адекватным объемом остающейся паренхимы печени. В настоящее время резектабельность определяют в большей мере по минимально допустимому объему нормально функционирующей печеночной паренхимы. В рамках новой парадигмы увеличивается число больных с потенциально резектабельным онкологическим процессом. Однако общепринятых понятий и критериев резектабельности не существует, что затрудняет выбор лечебной тактики и напрямую влияет на выживаемость больных. Поиск литературы для обзора осуществляли в системах PubMed, Cochrane Library, Google Scholar и еLibrary. Включали публикации, характеризующие современные возможности хирургии печени, направленные на увеличение резектабельности и улучшение онкологических результатов у больных колоректальным раком с метастазами в печени.

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