Zentralblatt für Chirurgie
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In this review, standards of diagnosis and treatment of colorectal liver metastases are described on the basis of a workshop discussion. Algorithms of care for patients with synchronous / metachronous colorectal liver metastases or locoregional recurrent tumour are presented. Surgical resection is the procedure of choice in the curative treatment of liver metastases. ⋯ Patients with tumours larger than 3 cm have a high local recurrence rate after percutaneous RFA and are not optimal candidates for this procedure. The physician's experience influences the results significantly, both after hepatectomy and after in situ ablation. Therefore, patients with colorectal liver metastases should be treated in centres with experience in liver surgery.
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Symptomatic malignant pleural effusions are common in patients with neoplastic disease (50 %). Frequently, they are a sign of advanced disease. These patients have an average life expectancy of 3 to 12 months. ⋯ Talc is the most effective sclerosant (80 %) followed by doxycycline (70 %). VATS pleurodesis has a higher complication rate but is more effective than a talc slurry instilled through the chest tube. When the lung is trapped, long-term indwelling pleural drainage and pleuroperitoneal shunts are alternatives.