| Objective To compare clinical outcomes and safety of repeat hepatectomy for patients with liver metastases from colorectal cancer with those of a first liver resection.Methods The literature was searched for all studies reported on repeat hepatectomy versus a first liver resection patients with liver metastases from colorectal cancer between January 1991 to July 2007. Two authors independently extracted data using the following outcomes: postoperative complications and mortality; disease recurrence; and long-term survival. Trials were assessed using the modified Newcastle-Ottawa Score.Date analysis were performed by RevMan 4.2.Results According to the same screening criteria, 22 clinical studies were included in our systematic reviews. Sample volume in this Meta analysis was 3750 liver metastases from colorectal cancer cases. Operation time and intraoperatie blood transfusions are statistically significant differences(P<0.05)。In comparision with the first liver resection group, Operation time of the repeat hepatectomy group was longer by 39 minutes,[95%CI(-65.21,-23.13), P<0.00001], intraoperatie blood transfusions was longer by 1.1 U, [95%CI(-1.75,-0.79), P<0.00001] .There were no significant differences in the number of patient of intraoperatie blood transfusions, number of bleeding patient, length of intensive care unit stay,length of hospitalization (P>0.05). There were no significant differences in the morbidity rate of post-operation complications,3-year overall survival, 5-year overall survival, the incidence of recurrence between the two groups.Conclusions Repeat hepatectomy for patients with colorectal cancer metastases is safe and provides survival benefit equal to that of a first liver resection. Repeat hepatectomy is first selection scheme, but in order to get a more effective long-term outcome, further consider comprehensive treatment should be considered. |
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