Editorial
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2019; 11(2): 34-40
Published online Feb 27, 2019. doi: 10.4240/wjgs.v11.i2.34
Pushing the limits of liver surgery for colorectal liver metastases: Current state and future directions
Raphael LC Araujo, Marcelo M Linhares
Raphael LC Araujo, Marcelo M Linhares, Department of Digestive Surgery, Escola Paulista de Medicina - UNIFESP, São Paulo SP 04023-062, Brazil
Raphael LC Araujo, Department of Oncology, Americas Medical Service/Brazil, United Health Group, Sao Paulo SP 04023-062, Brazil
Raphael LC Araujo, Postgraduation Program, Barretos Cancer Hospital, Barretos, São Paulo SP 04023-062, Brazil
Author contributions: All authors participated in the writing and editing of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Raphael LC Araujo, MD, PhD, Associate Professor, Surgical Oncologist, Associate Professor of Liver Surgery, Department of Digestive Surgery, Escola Paulista de Medicina - UNIFESP, Rua Botucatu, 740, Vila Clementino, São Paulo SP 04023-062, Brazil. raphael.l.c.araujo@gmail.com
Telephone: +55-11-55764053 Fax: +55-11-55764053
Received: December 17, 2018
Peer-review started: December 17, 2018
First decision: December 17, 2018
Revised: January 23, 2019
Accepted: January 30, 2019
Article in press: January 30, 2019
Published online: February 27, 2019
Abstract

Liver surgery for the treatment of colorectal liver metastases is the standard treatment in a dynamic surgical field with many variables that should be considered in a curative intent scenario. Hepatectomy for colorectal liver metastases has undergone constant changes over the last 30 years, including indications until the need for rescue procedures of recurrent and advanced diseases as well as minimally invasive surgery. These advancements in liver surgery have not only resulted from overall improvements in the surgical field but have also resulted from a better understanding of the biological behavior of the disease, liver regeneration, and homeostasis during and after surgery. Improvements in anesthesiology, intensive care medicine, radiology, and surgical devices have correlated with further advancements of hepatectomies. Moreover, changes are still forthcoming, and both fields of augmented reality and artificial intelligence will likely have future contributions in this field in regard to both diagnoses and the planning of procedures. The aim of this editorial is to emphasize several aspects that have contributed to the paradigm shifts in colorectal liver metastases surgery over the last three decades as well as to discuss the factors concerning patient selection and the technical aspects of liver surgery. Finally, this editorial will highlight the promising new features of this surgery for diagnoses and treatments in this field.

Keywords: Colorectal liver metastases, Cancer, Hepatectomy, Liver, Surgery, Oncology

Core tip: Liver surgery for colorectal liver metastases is a dynamic field, and its limits have considerably changed over the last three decades. Many variables have influenced patient selection and surgical techniques, and more changes are forthcoming with improvements in minimally invasive surgery, radiology, and artificial intelligence. This editorial highlights the pathway of treating colorectal liver metastases over three decades and the promising features in this field.