[Surgical treatment of colorectal liver metastases].

Surgical resection of the metastases offers the only opportunity for long-term survival in colorectal liver metastases. However, only 10% to 20% of patients present with resectable disease, and so how to increase surgical patients has been a clinical hotspot. In addition to expanding surgical indications, two-stage hepatectomy and convertible therapy are optional. In convertible therapy, initial treatment regimen decides long-term benefit, and it is important to select appropriate patient population in addition to Ras status when anti-epithelial growth factor receptor monoclonal antibody is used. Minimally invasive surgery can also be used for liver resection and simultaneous resection, and it is safe and effective. For patients with colorectal cancer and unresectable asymptomatic liver metastases, the debate continues over the efficacy of primary resection compared to chemotherapy alone, limited by lack of prospective evidence. Therefore, multidisciplinary team assessment is essential to optimize outcomes in colorectal liver metastases.手术切除为结直肠癌肝转移患者长期生存提供了唯一的机会。然而，只有10%～20%的肿瘤在患者初次就诊时可切除，如何增加结直肠癌肝转移患者的手术切除机会一直是临床研究热点。除扩大肝转移灶手术适应证外，还可选择二步肝切除术、转化治疗等策略。在行转化治疗时，一线治疗方案的选择尤为重要。在应用抗表皮生长因子受体单抗时，除检测Ras基因外，还应进一步精确选择合适的患者。随着微创技术的普及，已有研究结果证实应用微创技术进行肝切除或肠肝同步切除是安全可行的。对于转移灶不可切除的同时性结直肠癌肝转移患者是否切除无症状的原发灶，尚缺乏明确的前瞻性研究证据。总而言之，结直肠癌肝转移患者诊治过程中，多学科团队对患者进行评估至关重要。.