当结直肠癌确诊并发现伴有同时性肝转移时，原发灶和转移灶手术时机的选择尚存争议。学术界传统观点是首先切除结直肠癌原发灶，然后再分期切除肝转移灶，但是近年来原发灶和转移灶同期切除的理念得到迅速发展，在一些特殊病例，甚至还会选择先切除肝转移灶，再切除原发灶的“逆向策略”。因此，当前结直肠癌伴同时性肝转移的外科治疗仍缺乏统一的规范，尚需高级别循证医学证据来支持。对于每例结直肠癌肝转移病人，需经过多学科查房讨论，制定个体化的综合治疗方案。

Surgical strategies for colorectal liver metastases: synchronous resection or staged resection        SU Xiang-qian, YANG Hong. Department of Minimally Invasive Gastrointestinal Surgery，Beijing Cancer Hospital & Institute, Peking University Cancer Hospital，Peking University School of Oncology，Key laboratory of Carcinogenesis and Translational Research (Ministry of Education)，Beijing 100142，China
Corresponding author: SU Xiang-qian，E-mail: suxiangqian@gmail.com
Abstract    When liver metastases are diagnosed concurrently with the primary colorectal cancer, the timing of surgical intervention remains controversial. Traditionally most centers have adopted a staged treatment with the colorectal primary being dealt with first, followed by hepatic resection. However recently there has been increasing enthusiasm for synchronous surgical management, or in some cases, a liver first approach. Therefore, the surgical management of patients with synchronous colorectal metastases has not been clearly defined, still needs the support of high-level evidence. As for each patient, multidisciplinary therapy (MDT) should be advocated, in order to formulate individualized therapeutic regimen.