Anatomical vs. Wedge Hepatic Resection. Our Experience about 31 Consecutive Patients with Hepatic Metastases from Colorectal Cancer

Introduction: Surgical resection may be the only treatment modality for the cure of colorectal liver metastases (CLM). This study was aimed at analysing our experience on hepatic liver nonanatomical or anatomical resection for colorectal metastases. Methods: 31 patients who underwent anatomical or wedge hepatic resection for CLM between 1996 and 2006 were analysed. Results: The metastases were synchronous in 17 cases (54.8%) and metachronous in 14 (45.2%); they were located in a single lobe in 22 cases (71%), while both hepatic lobes resulted to be involved in 9 cases. The treatment choice was conditioned by the number of the metastases and their localization: 21 wedge and 10 anatomical resections were performed. No p.o. deaths were observed and the overall morbidity rate was 12.9%, without significant differences between two groups. The overall 3-year survival rate was 34.1%. Patients with synchronous metastases, bilobar localization or more than 3 metastases had a worse prognosis. Anatomical and wedge resection had a 3-year survival rate of 45 and 24.6%, respectively (p 0.59). Discussion: Hepatic resection for metastatic colorectal cancer provides long-term survival in selected patients both with wedge or anatomic resections. The choice of the technical drift from the number and the site of metastases.