What are the surgical methods for rectal cancer liver metastasis

Rectal cancer is a common intestinal tumor. Its early symptoms are not obvious and it is easy to spread and metastasize. Patients with rectal cancer liver metastasis should choose appropriate surgical methods to obtain the best treatment effect.

1. Patients with liver metastasis when rectal cancer is diagnosed

Synchronous resection of the primary lesion of rectal cancer and liver metastases is recommended in the following situations: when the liver metastases are small and mostly located in the periphery or confined to half the liver, the liver resection volume is less than 50%, and the hilar lymph nodes, abdominal cavity or other distant metastases can all be surgically removed.

In the following cases, it is recommended to resect the primary lesion of rectal cancer and liver metastasis in stages: 1. First, surgically resect the primary lesion of rectal cancer, and then resect the liver metastasis in stages, usually 4 to 6 weeks after radical surgery for rectal cancer. 2. If treatment is performed before surgery for liver metastasis, resection of liver metastasis can be postponed to within 3 months after resection of the primary lesion. 3. Simultaneous resection of primary colorectal cancer and liver metastasis is not recommended for emergency surgery.

2. Choice of surgical approach for liver metastases

After resection of liver metastases, at least one of the three hepatic veins should be retained and the residual liver volume should be ≥50% or ≥30%; the surgical margin of the metastasis should generally have about 1 cm of normal liver tissue. If the metastasis is in a special location, such as close to a large blood vessel, it is not necessary to be too demanding; if the liver metastasis is large and limited to the left or right half of the liver and there is no cirrhosis, regular hemihepatectomy can be performed; it is recommended to use intraoperative ultrasound examination during liver metastasis surgery, which helps to detect liver metastases that have not been diagnosed by preoperative imaging examinations, so as to ensure the completeness and thoroughness of the operation.