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Immediate results of surgical treatment of colorectal cancer with synchronous liver metastases

https://dx.doi.org/10.51350/zdravkg2022.4.10.23.163
Immediate results of surgical treatment of colorectal cancer with synchronous liver metastases
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Abstract About the authors References

Abstract

The management of patients with synchronous metastatic colorectal cancer (SMCRC) remains a challenge for an interdisciplinary team. The results of a simultaneous surgical strategy, in combination with resection of the primary malignant neoplasm and liver metastases, avoid complications during a major re-operation, theoretically reduce the risk of dissemination of the disease, and allow adjuvant therapy to be completed in a timely manner. Therefore, it is unclear to what extent this surgical strategy is applied in the general population and whether comparable results are achieved. Simultaneous removal of primary colorectal cancer (CRC) and synchronous liver metastases (LIC) is of increasing interest.The purpose of the study -to conduct a comparative analysis of the immediate results of synchronous and staged surgical treatment of patients with SMCRC.Material and methods. The results of treatment of 41 patients with MCRC with synchronous liver damage, who underwent synchronous (group A, n=21) and staged resections (group B, n=20) of the liver in the department of intestinal tumors of the National Center of Oncology and Hematology of the Ministry of Health of the Kyrgyz Republic during the period from 2010 to 2020. Results. The total level of postoperative complications in groups A and B after the completion of the surgical stages did not differ statistically. A shorter duration of surgery was registered in group A — 316.3±10.3 minutes, while in group B it was 484.1±18.3 minutes (p<0.001). Patients after staged resections stayed longer in the hospital - 21.1±0.7 bed-days, while after synchronous resections - 10.32±0.6 bed-days (p<0.001). Conclusions.An analysis of our studies indicates the need to develop a differentiated approach to the surgical treatment of SMCR.

About the authors

Осомбаев Муратбек Шаршембиевич, к.м.н. доцен, заведующий отделением опухолей кишечника Национального центра онкологии и гематологии при МЗ КР, Бишкек, Кыргызская Республика
Абдрасулов Каныбек Дуйшобекович, аспирант кафедры онкологии и лучевой терапии Кыргызского государственного медицинского института переподготовки и повышения квалификации им. С.Б. Даниярова; врач онколог Национального центра онкологии и гематологии при МЗ КР, Бишкек, Кыргызская Республика
Джекшенов Марат Джумабекович, врач онколог, научный сотрудник отделения опухолей кишечника Национального центра онкологии и гематологии, Бишкек, Кыргызская Республика

Osombaev Muratbek Sharshembievich, Ph.D. Associate Professor, Head of the Department of Intestinal Tumors of the National Center for Oncology and Hematology at the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyz Republic
Abdrasulov Kanybek Duishobekovich, graduate student of the Department of Oncology and Radiation Therapy of the Kyrgyz State Medical Institute for Retraining and Advanced Training named after S.B. Daniyarov; oncologist of the National Center for Oncology and Hematology at the Ministry of Health, Bishkek, Kyrgyz Republic
Djekshenov Marat Djumabekovich, oncologist, researcher at the Department of Intestinal Tumors of the National Center for Oncology and Hematology, Bishkek, Kyrgyz Republic

Осомбаев Муратбек Шаршембиевич, медицина илимдеринин кандидаты, Кыргыз Республикасынын Саламаттык сактоо министрлигине караштуу Улуттук онкология жана гематология борборунун ичеги шишиктери кафедрасынын доценти, Бишкек, Кыргыз Республикасы

Абдрасулов ​​Каныбек Дүйшөбекович, С.Б. Даниярова атындагы Кыргыз мамлекеттик кайра даярдоо жана квалификациясын жогорулатуу медициналык институтунун онкология жана радиациялык терапия кафедрасынын аспиранты; Кыргыз Республикасынын Саламаттык сактоо министрлигине караштуу Улуттук онкология жана гематология борборунун онкологу, Бишкек, Кыргыз Республикасы

Джекшенов Марат Жумабекович, илимий кызматкери, Улуттук онкология жана гематология борборунун ичеги шишиктери бөлүмүнүн онколог дарыгери,  Бишкек, Кыргыз Республикасы

 

References

1. Liu J, Xia Y, Pan X, Yan Z, Zhang L, Yang Z, Wu Y, Xue H, Bai S, Shen F, Wang K (2022). Simultaneous versus staged major hepatectomy (≥3 liver segments) for outcomes of synchronous colorectal liver metastases: A systematic review and meta-analysis.Cancer Rep (Hoboken). Aug;5(8):e1617. doi: 10.1002/cnr2.1617. Epub 2022 Jun 26. PMID: 35753719; PMCID: PMC9351651.
2. Coco D., Leanza S. (2019). Analysis of treatment options for synchronous liver metastases and rectal cancer. Open Access Maced J Med Sci. December 13th; 7(23):4176-4178. doi: 10.3889/oamjms.2019.796. PMID: 32165972; PMCID: PMC7061367.
3. de Haas RJ, Adam R. (2010). Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases.British J. Surgery, 97: 1279-89.
4. Yu X, et al. (2020). Emerging Role of Immunotherapy for Colorectal Cancer with Liver Metastasis. Onco Targets Ther. 13:11645–11658. [PMC free article] [PubMed] [Google Scholar] [Ref list].
5. Valderrama-Treviño AI, et al (2017). Hepatic Metastasis from Colorectal Cancer. Euroasian J. Hepatogastroenterol. 7:166–175.PMC free article] [PubMed] [Google Scholar].
6. Sidorov D.V., Lozhkin M.V., Troitsky A.A., (2020). Liver first technique in the treatment of colorectal cancer patients with synchronous liver metastases. Oncology. Journal them. P.A. Herzen. T. 9. No. 1. S. 45-49.].Gall TM, Basyouny M, Frampton AE,Darzi A, Ziprin P, Dawson P, Paraskeva P, Habib NA, Spalding DR, Cleator S, Lowdell C, Jiao LR.( 2014). Neoadjuvant chemotherapy and primary-first approach for rectal cancer with synchronous liver metastases.Col orectal.Dis.;16(6):197-205.https://doi.org/10.1111/codi.12534.
7. Solodkiy V.A., Akhaladze G.G., Grebenkin E.N., Goncharov S.V., Stanojevic U.S., Ivanova O.A. Simultaneous surgery for synchronous liver metastases of colorectal cancer: analysis of survival and negative prognosis factors. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(1):92-99. (In Russ.) https://doi.org/10.16931/1995-5464.2021192-99.
8. Lim C, Doussot A, Osseis M, Salloum C, Gomez Gavara C, Compagnon P, Brunetti F, Calderaro J, Azoulay D.( 2016). Primary tumor versus liver-first strategy in patients with stage IVA colorectal cancer: a propensity score analysis of long-term outcomes and recurrence pattern. Ann Surg Oncol.;23(9):3024-3032. https://doi.org/10.1245/s10434-016-5265-5.
9. Valdimarsson VT, Syk I, Lindell G, Norén A, Isaksson B, Sandström P, Rizell M, Ardnor B, Sturesson C. (2017). Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden. HPB (Oxford).20(5):441-447. https://doi.org/10.1016/j.hpb.2016.10.005.

1. Liu J, Xia Y, Pan X, Yan Z, Zhang L, Yang Z, Wu Y, Xue H, Bai S, Shen F, Wang K (2022). Simultaneous versus staged major hepatectomy (≥3 liver segments) for outcomes of synchronous colorectal liver metastases: A systematic review and meta-analysis.Cancer Rep (Hoboken). Aug;5(8):e1617. doi: 10.1002/cnr2.1617. Epub 2022 Jun 26. PMID: 35753719; PMCID: PMC9351651.
2. Coco D., Leanza S. (2019). Analysis of treatment options for synchronous liver metastases and rectal cancer. Open Access Maced J Med Sci. December 13th; 7(23):4176-4178. doi: 10.3889/oamjms.2019.796. PMID: 32165972; PMCID: PMC7061367.
3. de Haas RJ, Adam R. (2010). Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases.British J. Surgery, 97: 1279-89.
4. Yu X, et al. (2020). Emerging Role of Immunotherapy for Colorectal Cancer with Liver Metastasis. Onco Targets Ther. 13:11645–11658. [PMC free article] [PubMed] [Google Scholar] [Ref list].
5. Valderrama-Treviño AI, et al (2017). Hepatic Metastasis from Colorectal Cancer. Euroasian J. Hepatogastroenterol. 7:166–175.PMC free article] [PubMed] [Google Scholar].
6. Sidorov D.V., Lozhkin M.V., Troitsky A.A., (2020). Liver first technique in the treatment of colorectal cancer patients with synchronous liver metastases. Oncology. Journal them. P.A. Herzen. T. 9. No. 1. S. 45-49.].Gall TM, Basyouny M, Frampton AE,Darzi A, Ziprin P, Dawson P, Paraskeva P, Habib NA, Spalding DR, Cleator S, Lowdell C, Jiao LR.( 2014). Neoadjuvant chemotherapy and primary-first approach for rectal cancer with synchronous liver metastases.Col orectal.Dis.;16(6):197-205.https://doi.org/10.1111/codi.12534.
7. Solodkiy V.A., Akhaladze G.G., Grebenkin E.N., Goncharov S.V., Stanojevic U.S., Ivanova O.A. Simultaneous surgery for synchronous liver metastases of colorectal cancer: analysis of survival and negative prognosis factors. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(1):92-99. (In Russ.) https://doi.org/10.16931/1995-5464.2021192-99.
8. Lim C, Doussot A, Osseis M, Salloum C, Gomez Gavara C, Compagnon P, Brunetti F, Calderaro J, Azoulay D.( 2016). Primary tumor versus liver-first strategy in patients with stage IVA colorectal cancer: a propensity score analysis of long-term outcomes and recurrence pattern. Ann Surg Oncol.;23(9):3024-3032. https://doi.org/10.1245/s10434-016-5265-5.
9. Valdimarsson VT, Syk I, Lindell G, Norén A, Isaksson B, Sandström P, Rizell M, Ardnor B, Sturesson C. (2017). Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden. HPB (Oxford).20(5):441-447. https://doi.org/10.1016/j.hpb.2016.10.005.

1. Liu J, Xia Y, Pan X, Yan Z, Zhang L, Yang Z, Wu Y, Xue H, Bai S, Shen F, Wang K (2022). Simultaneous versus staged major hepatectomy (≥3 liver segments) for outcomes of synchronous colorectal liver metastases: A systematic review and meta-analysis.Cancer Rep (Hoboken). Aug;5(8):e1617. doi: 10.1002/cnr2.1617. Epub 2022 Jun 26. PMID: 35753719; PMCID: PMC9351651.
2. Coco D., Leanza S. (2019). Analysis of treatment options for synchronous liver metastases and rectal cancer. Open Access Maced J Med Sci. December 13th; 7(23):4176-4178. doi: 10.3889/oamjms.2019.796. PMID: 32165972; PMCID: PMC7061367.
3. de Haas RJ, Adam R. (2010). Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases.British J. Surgery, 97: 1279-89.
4. Yu X, et al. (2020). Emerging Role of Immunotherapy for Colorectal Cancer with Liver Metastasis. Onco Targets Ther. 13:11645–11658. [PMC free article] [PubMed] [Google Scholar] [Ref list].
5. Valderrama-Treviño AI, et al (2017). Hepatic Metastasis from Colorectal Cancer. Euroasian J. Hepatogastroenterol. 7:166–175.PMC free article] [PubMed] [Google Scholar].
6. Sidorov D.V., Lozhkin M.V., Troitsky A.A., (2020). Liver first technique in the treatment of colorectal cancer patients with synchronous liver metastases. Oncology. Journal them. P.A. Herzen. T. 9. No. 1. S. 45-49.].Gall TM, Basyouny M, Frampton AE,Darzi A, Ziprin P, Dawson P, Paraskeva P, Habib NA, Spalding DR, Cleator S, Lowdell C, Jiao LR.( 2014). Neoadjuvant chemotherapy and primary-first approach for rectal cancer with synchronous liver metastases.Col orectal.Dis.;16(6):197-205.https://doi.org/10.1111/codi.12534.
7. Solodkiy V.A., Akhaladze G.G., Grebenkin E.N., Goncharov S.V., Stanojevic U.S., Ivanova O.A. Simultaneous surgery for synchronous liver metastases of colorectal cancer: analysis of survival and negative prognosis factors. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(1):92-99. (In Russ.) https://doi.org/10.16931/1995-5464.2021192-99.
8. Lim C, Doussot A, Osseis M, Salloum C, Gomez Gavara C, Compagnon P, Brunetti F, Calderaro J, Azoulay D.( 2016). Primary tumor versus liver-first strategy in patients with stage IVA colorectal cancer: a propensity score analysis of long-term outcomes and recurrence pattern. Ann Surg Oncol.;23(9):3024-3032. https://doi.org/10.1245/s10434-016-5265-5.
9. Valdimarsson VT, Syk I, Lindell G, Norén A, Isaksson B, Sandström P, Rizell M, Ardnor B, Sturesson C. (2017). Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden. HPB (Oxford).20(5):441-447. https://doi.org/10.1016/j.hpb.2016.10.005.

Keywords
metastatic colorectal cancer , synchronous liver metastases , боордун синхрондуу жана этаптуу резекциясы
Для цитирования

Осомбаев М.Ш., Абдрасулов К.Д., Джекшенов М.Дж. Непосредственные результаты хирургического лечения колоректального рака синхронными метастазами в печень. Здравоохранение Кыргызстана 2022, № 4, с. 163-167. https://dx.doi.org/10.51350/zdravkg2022.4.10.23.163
For citation

Osombaev M.Sh., Abdrasulov K.D.,Dzhekshenov M.J.Immediate results of surgical treatment of colorectal cancer with
synchronous liver metastases. Health care of Kyrgyzstan 2022,No.4,pp.163-167. https://dx.doi.org/10.51350/zdravkg2022.4.10.23.163
Цитата үчүн

Осомбаев М.Ш., Абдрасулов К.Д., Джекшенов М.Дж. Боордун синхрондуу метастаздары менен колоректалдык ракты хирургиялык дарылоонун дароо натыйжалары. Кыргызстандын саламаттык сактоо 2022, no 4, б. 163-167.https://dx.doi.org/10.51350/zdravkg2022.4.10.23.163
Authors Osombaev M.Sh., Abdrasulov K.D., Dzhekshenov M.J.
Link doi.org https://dx.doi.org/10.51350/zdravkg2022.4.10.23.163
Pages 163-167
Keywords metastatic colorectal cancer, synchronous liver metastases, боордун синхрондуу жана этаптуу резекциясы
Russian
Об авторах

Осомбаев Муратбек Шаршембиевич, к.м.н. доцен, заведующий отделением опухолей кишечника Национального центра онкологии и гематологии при МЗ КР, Бишкек, Кыргызская Республика
Абдрасулов Каныбек Дуйшобекович, аспирант кафедры онкологии и лучевой терапии Кыргызского государственного медицинского института переподготовки и повышения квалификации им. С.Б. Даниярова; врач онколог Национального центра онкологии и гематологии при МЗ КР, Бишкек, Кыргызская Республика
Джекшенов Марат Джумабекович, врач онколог, научный сотрудник отделения опухолей кишечника Национального центра онкологии и гематологии, Бишкек, Кыргызская Республика
Полный текст

PDF (RUS)
Список литературы

1. Liu J, Xia Y, Pan X, Yan Z, Zhang L, Yang Z, Wu Y, Xue H, Bai S, Shen F, Wang K (2022). Simultaneous versus staged major hepatectomy (≥3 liver segments) for outcomes of synchronous colorectal liver metastases: A systematic review and meta-analysis.Cancer Rep (Hoboken). Aug;5(8):e1617. doi: 10.1002/cnr2.1617. Epub 2022 Jun 26. PMID: 35753719; PMCID: PMC9351651.
2. Coco D., Leanza S. (2019). Analysis of treatment options for synchronous liver metastases and rectal cancer. Open Access Maced J Med Sci. December 13th; 7(23):4176-4178. doi: 10.3889/oamjms.2019.796. PMID: 32165972; PMCID: PMC7061367.
3. de Haas RJ, Adam R. (2010). Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases.British J. Surgery, 97: 1279-89.
4. Yu X, et al. (2020). Emerging Role of Immunotherapy for Colorectal Cancer with Liver Metastasis. Onco Targets Ther. 13:11645–11658. [PMC free article] [PubMed] [Google Scholar] [Ref list].
5. Valderrama-Treviño AI, et al (2017). Hepatic Metastasis from Colorectal Cancer. Euroasian J. Hepatogastroenterol. 7:166–175.PMC free article] [PubMed] [Google Scholar].
6. Sidorov D.V., Lozhkin M.V., Troitsky A.A., (2020). Liver first technique in the treatment of colorectal cancer patients with synchronous liver metastases. Oncology. Journal them. P.A. Herzen. T. 9. No. 1. S. 45-49.].Gall TM, Basyouny M, Frampton AE,Darzi A, Ziprin P, Dawson P, Paraskeva P, Habib NA, Spalding DR, Cleator S, Lowdell C, Jiao LR.( 2014). Neoadjuvant chemotherapy and primary-first approach for rectal cancer with synchronous liver metastases.Col orectal.Dis.;16(6):197-205.https://doi.org/10.1111/codi.12534.
7. Solodkiy V.A., Akhaladze G.G., Grebenkin E.N., Goncharov S.V., Stanojevic U.S., Ivanova O.A. Simultaneous surgery for synchronous liver metastases of colorectal cancer: analysis of survival and negative prognosis factors. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(1):92-99. (In Russ.) https://doi.org/10.16931/1995-5464.2021192-99.
8. Lim C, Doussot A, Osseis M, Salloum C, Gomez Gavara C, Compagnon P, Brunetti F, Calderaro J, Azoulay D.( 2016). Primary tumor versus liver-first strategy in patients with stage IVA colorectal cancer: a propensity score analysis of long-term outcomes and recurrence pattern. Ann Surg Oncol.;23(9):3024-3032. https://doi.org/10.1245/s10434-016-5265-5.
9. Valdimarsson VT, Syk I, Lindell G, Norén A, Isaksson B, Sandström P, Rizell M, Ardnor B, Sturesson C. (2017). Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden. HPB (Oxford).20(5):441-447. https://doi.org/10.1016/j.hpb.2016.10.005.
Для цитирования

Осомбаев М.Ш., Абдрасулов К.Д., Джекшенов М.Дж. Непосредственные результаты хирургического лечения колоректального рака синхронными метастазами в печень. Здравоохранение Кыргызстана 2022, № 4, с. 163-167. https://dx.doi.org/10.51350/zdravkg2022.4.10.23.163
English
About authors

Osombaev Muratbek Sharshembievich, Ph.D. Associate Professor, Head of the Department of Intestinal Tumors of the National Center for Oncology and Hematology at the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyz Republic
Abdrasulov Kanybek Duishobekovich, graduate student of the Department of Oncology and Radiation Therapy of the Kyrgyz State Medical Institute for Retraining and Advanced Training named after S.B. Daniyarov; oncologist of the National Center for Oncology and Hematology at the Ministry of Health, Bishkek, Kyrgyz Republic
Djekshenov Marat Djumabekovich, oncologist, researcher at the Department of Intestinal Tumors of the National Center for Oncology and Hematology, Bishkek, Kyrgyz Republic
References

1. Liu J, Xia Y, Pan X, Yan Z, Zhang L, Yang Z, Wu Y, Xue H, Bai S, Shen F, Wang K (2022). Simultaneous versus staged major hepatectomy (≥3 liver segments) for outcomes of synchronous colorectal liver metastases: A systematic review and meta-analysis.Cancer Rep (Hoboken). Aug;5(8):e1617. doi: 10.1002/cnr2.1617. Epub 2022 Jun 26. PMID: 35753719; PMCID: PMC9351651.
2. Coco D., Leanza S. (2019). Analysis of treatment options for synchronous liver metastases and rectal cancer. Open Access Maced J Med Sci. December 13th; 7(23):4176-4178. doi: 10.3889/oamjms.2019.796. PMID: 32165972; PMCID: PMC7061367.
3. de Haas RJ, Adam R. (2010). Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases.British J. Surgery, 97: 1279-89.
4. Yu X, et al. (2020). Emerging Role of Immunotherapy for Colorectal Cancer with Liver Metastasis. Onco Targets Ther. 13:11645–11658. [PMC free article] [PubMed] [Google Scholar] [Ref list].
5. Valderrama-Treviño AI, et al (2017). Hepatic Metastasis from Colorectal Cancer. Euroasian J. Hepatogastroenterol. 7:166–175.PMC free article] [PubMed] [Google Scholar].
6. Sidorov D.V., Lozhkin M.V., Troitsky A.A., (2020). Liver first technique in the treatment of colorectal cancer patients with synchronous liver metastases. Oncology. Journal them. P.A. Herzen. T. 9. No. 1. S. 45-49.].Gall TM, Basyouny M, Frampton AE,Darzi A, Ziprin P, Dawson P, Paraskeva P, Habib NA, Spalding DR, Cleator S, Lowdell C, Jiao LR.( 2014). Neoadjuvant chemotherapy and primary-first approach for rectal cancer with synchronous liver metastases.Col orectal.Dis.;16(6):197-205.https://doi.org/10.1111/codi.12534.
7. Solodkiy V.A., Akhaladze G.G., Grebenkin E.N., Goncharov S.V., Stanojevic U.S., Ivanova O.A. Simultaneous surgery for synchronous liver metastases of colorectal cancer: analysis of survival and negative prognosis factors. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(1):92-99. (In Russ.) https://doi.org/10.16931/1995-5464.2021192-99.
8. Lim C, Doussot A, Osseis M, Salloum C, Gomez Gavara C, Compagnon P, Brunetti F, Calderaro J, Azoulay D.( 2016). Primary tumor versus liver-first strategy in patients with stage IVA colorectal cancer: a propensity score analysis of long-term outcomes and recurrence pattern. Ann Surg Oncol.;23(9):3024-3032. https://doi.org/10.1245/s10434-016-5265-5.
9. Valdimarsson VT, Syk I, Lindell G, Norén A, Isaksson B, Sandström P, Rizell M, Ardnor B, Sturesson C. (2017). Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden. HPB (Oxford).20(5):441-447. https://doi.org/10.1016/j.hpb.2016.10.005.
For citation

Osombaev M.Sh., Abdrasulov K.D.,Dzhekshenov M.J.Immediate results of surgical treatment of colorectal cancer with
synchronous liver metastases. Health care of Kyrgyzstan 2022,No.4,pp.163-167. https://dx.doi.org/10.51350/zdravkg2022.4.10.23.163
Kyrgyz
Авторлор жөнүндө

Осомбаев Муратбек Шаршембиевич, медицина илимдеринин кандидаты, Кыргыз Республикасынын Саламаттык сактоо министрлигине караштуу Улуттук онкология жана гематология борборунун ичеги шишиктери кафедрасынын доценти, Бишкек, Кыргыз Республикасы

Абдрасулов ​​Каныбек Дүйшөбекович, С.Б. Даниярова атындагы Кыргыз мамлекеттик кайра даярдоо жана квалификациясын жогорулатуу медициналык институтунун онкология жана радиациялык терапия кафедрасынын аспиранты; Кыргыз Республикасынын Саламаттык сактоо министрлигине караштуу Улуттук онкология жана гематология борборунун онкологу, Бишкек, Кыргыз Республикасы

Джекшенов Марат Жумабекович, илимий кызматкери, Улуттук онкология жана гематология борборунун ичеги шишиктери бөлүмүнүн онколог дарыгери,  Бишкек, Кыргыз Республикасы

 
Шилтемелер

1. Liu J, Xia Y, Pan X, Yan Z, Zhang L, Yang Z, Wu Y, Xue H, Bai S, Shen F, Wang K (2022). Simultaneous versus staged major hepatectomy (≥3 liver segments) for outcomes of synchronous colorectal liver metastases: A systematic review and meta-analysis.Cancer Rep (Hoboken). Aug;5(8):e1617. doi: 10.1002/cnr2.1617. Epub 2022 Jun 26. PMID: 35753719; PMCID: PMC9351651.
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Цитата үчүн

Осомбаев М.Ш., Абдрасулов К.Д., Джекшенов М.Дж. Боордун синхрондуу метастаздары менен колоректалдык ракты хирургиялык дарылоонун дароо натыйжалары. Кыргызстандын саламаттык сактоо 2022, no 4, б. 163-167.https://dx.doi.org/10.51350/zdravkg2022.4.10.23.163
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