Chernev V. Laparoscopic cryodestruction of liver metastases in the complex treatment of colorectal cancer

Dissertation dedicated to the solution of scientific problem dedicated to treatment techniques optimization for patients with colorectal cancer liver metastases. The results of treatment of 122 patients divided into 3 groups were analyzed. Using isolated palliative chemotherapy and symptomatic treatment were ineffective in control group (60 patients). In 1-st group (28 patients): using only laparoscopic cryodestruction detected metastatic centers were destroyed but there was impossible to prevent appearance of new micrometastases that were inaccessible for diagnosis in other liver segments. That's why it is obligatory to add a chemotherapy to this technique. Laparoscopic cryodestruction should be used only in complex with other treatment methods. The complex technique was developed and was used in 2-nd group (34 patients). Using the complex technique complete regression of tumor was noted. Partial regression was observed. Stabilization of tumor growth (decrease the volume of lesion less than 30%) was in patients with cryodestruction. The progression of tumor growth (increase in size one of the metastases or appearance of new metastatic lesions) was noted. Therefore, complex treatment with use of laparoscopic cryodestruction, endovascular surgery, local using of cytostatic and chemotherapy in patients with 4-th stage of colorectal cancer with multiple liver metastases with lesion volume more than 50% of liver allows to avoid tumor progression and appearance of new metastatic lesions in other liver segments. We achieved stabilization of tumor process and increase quality and duration of life of inoperable patients. Complex approach significantly improves treatment results, increase length of live and life quality in patients with liver metastases. Developed treatment technique could be the method of choice for patients with multiple liver metastases.