Combined Hepatectomy and Hepatic Artery Catheter Implantation and Irinotecan Infusion is Safe and Effective for Colorectal Cancer with Liver Metastases

肝動脈導管植入與肝臟切除手術同時進行於大腸癌肝臟轉移病人之治療對於術後肝功能復原之影響

許至偉(Chih-Wei Hsu) ； 于家珩(Chia-Herng Yue) ； 張子明(Tze-Ming Chang) ； 張瀛澤(Ying-Tse Chang)

《台灣癌症醫學雜誌》 28卷1期 (2012/02) Pp. 18-27

https://doi.org/10.6323/JoCRP.2012.28.1.2

摘要

Background: Hepatic artery infusion chemotherapy for colorectal liver metastases is considered to be an important patient treatment option due to higher regional concentration and lower systemic toxicity. This study was conducted to compare the liver function recovery between patients who received liver resection combined with or without hepatic artery catheter implantation.Methods: Our study is based on retrospective data of thirteen patients with colorectal liver metastases who all underwent either hepatectomy procedure (group 1, n = 7) or combined hepatic artery catheter implantation (group 2, n = 6). The hepatic artery catheter was implanted via the gastroduodenal artery to the proper hepatic artery, and the reservoir was fixed in the right lower quadrant abdominal wall. Blood sampling for liver function test was performed on preoperative and postoperative day 1, 3, 7, and year 1. The data were analyzed with Mann-Whitney test and P ＜ 0.05 was considered significant.Results: It needs more 25.16 (15-42) minutes for hepatic artery catheter implantation. There were two hepatic artery catheters removed in the 2nd month and 6th month after operation due to catheter dislodgement and obstruction. We examined the blood samples of the two groups, which showed no significant difference.Conclusions: Hepatic artery catheter implantation combined with hepatectomy for metastatic liver disease is safe and is beneficial in patients who are at a high risk of recurrence.

關鍵字

大腸癌 ； 肝轉移 ； 肝動脈灌注化療

並列摘要

Background: Hepatic artery infusion chemotherapy for colorectal liver metastases is considered to be an important patient treatment option due to higher regional concentration and lower systemic toxicity. This study was conducted to compare the liver function recovery between patients who received liver resection combined with or without hepatic artery catheter implantation.Methods: Our study is based on retrospective data of thirteen patients with colorectal liver metastases who all underwent either hepatectomy procedure (group 1, n = 7) or combined hepatic artery catheter implantation (group 2, n = 6). The hepatic artery catheter was implanted via the gastroduodenal artery to the proper hepatic artery, and the reservoir was fixed in the right lower quadrant abdominal wall. Blood sampling for liver function test was performed on preoperative and postoperative day 1, 3, 7, and year 1. The data were analyzed with Mann-Whitney test and P ＜ 0.05 was considered significant.Results: It needs more 25.16 (15-42) minutes for hepatic artery catheter implantation. There were two hepatic artery catheters removed in the 2nd month and 6th month after operation due to catheter dislodgement and obstruction. We examined the blood samples of the two groups, which showed no significant difference.Conclusions: Hepatic artery catheter implantation combined with hepatectomy for metastatic liver disease is safe and is beneficial in patients who are at a high risk of recurrence.

並列關鍵字

colorectal cancer ； liver metastasis ； hepatic artery infusion chemotherapy