[Results from application of a portal vein ligature at surgical treatment of primarily unresectable colorectal liver metastases].

Introduction: Selected patients with unresectable colorectal liver metastases (CRLM) may become resectable using a two-step approach with portal vein ligature (PVL). The purpose of this study is the evaluation of the results of the tow-staged liver resection (LR) using PVL for CRLM in our clinic. Material and Methods: During the period 2005-2015 year at the Clinic of hepatobiliary and transplant surgery, MMA-Sofia 290 curative LR for CRL were carried out. In 17 (5.9%) of them is used a two-stage approach with an initial PVL. Results: The reasons for unresectability were multinodularity of the disease in 70.6%, the size of LM (11.8%), poor location (17.6%). Synchronous LM was at 94% of the cases. Simultaneous resection of the primary tumor at the first operation carried out in 58.8% of the cases. During the second operation, at 94% of patients require a major LR. Patients completed a two-staged approach median survival was 40.43 m., with a found that extended right hemihepatectomy adversely affect survival in patients with two-stage hepatectomy (p=0.023), increasing the risk over 6 times. Conclusion: The multidisciplinary approach is the most precise form, ensuring proper selection and behavior in patients under consideration for two-stage approach to optimize the therapeutic behavior and clinical outcomes.

AN APPROACH TO THE DETERMINATION OF A PROGNOSTIC INDEX FOR THE SCOPE OF SIMULTANEOUS RESECTION IN PATIENTS WITH SYNCHRONOUS COLORECTAL LIVER METASTASES.

Based on the results of 62 simultaneous operations in patients with synchronous liver metastases from colorectal cancer, an attempt was made to calculate the index, assisting the surgeon in the selection of the liver resection, considering the sensitivity and specificity of the test. The index is calculated using equations based on variables and their coefficients from Cox regression analysis. The type of surgery is associated with prognosis for survival of the operated patients. The results can serve as a basis for further research in this area.