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Liver resection technique

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https://www.readbyqxmd.com/read/28631103/transesophageal-echocardiography-in-orthotopic-liver-transplantation-a-comprehensive-intraoperative-monitoring-tool
#1
REVIEW
Luigi Vetrugno, Federico Barbariol, Umberto Baccarani, Francesco Forfori, Giovanni Volpicelli, Giorgio Della Rocca
Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28628012/curative-treatment-of-colorectal-cancer-solitary-metastasis-to-liver-subcapsule-by-percutaneous-us-guided-radiofrequency-ablation-using-hydrodissection-case-report
#2
N Paksashvili, T Ninikashvili, T Azrumelashvili, M Mizandari
Case report presents the successful treatment of solitary liver metastasis in a patient with resected colon cancer. A 39-year-old male underwent left hemicolectomy with colostomy formation followed by chemotherapy for a moderately differentiated adenocarcinoma of the colon. Two years later, a liver metastatic lesion was detected. Patient received chemotherapy; the mass remained stable in size, measuring up to 3 cm in diameter. Low-invasive percutaneous curative treatment by Radiofrequency ablation was conducted using hydrodissection by dielectric fluid intraperitoneal introduction for hydrodissection...
May 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28625391/twelve-year-experience-of-radical-but-conservative-liver-surgery-for-colorectal-metastases-impact-on-surgical-practice-and-oncologic-efficacy
#3
Guido Torzilli, Luca Viganò, Andrea Gatti, Guido Costa, Matteo Cimino, Fabio Procopio, Matteo Donadon, Daniele Del Fabbro
BACKGROUND: Liver surgery for colorectal metastases (CLM) is moving toward parenchyma-sparing approaches. The authors reported the technical feasibility of parenchyma-sparing hepatectomy for deeply located tumors, but its impact on daily practice and long-term outcomes remain unclear. METHODS: The patients undergoing liver resection (LR) for CLM with vascular contact (first-/second-order pedicle or hepatic vein (HV) trunk) were considered. Those undergoing major hepatectomy were excluded...
June 16, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28624558/safety-and-feasibility-of-electrochemotherapy-in-patients-with-unresectable-colorectal-liver-metastases-a-pilot-study
#4
Laura Coletti, Valentina Battaglia, Paolo De Simone, Laura Turturici, Carlo Bartolozzi, Franco Filipponi
BACKGROUND AND OBJECTIVES: Electrochemotherapy is a novel ablation technique combining chemotherapeutic agents with reversible cell membrane electroporation. Previous experiences have shown its efficacy for cutaneous tumors. Its application for deep-seated malignancies is under investigation. We performed a prospective, pilot study to evaluate the feasibility, safety, and efficacy of intraoperative electrochemotherapy for otherwise unresectable colorectal liver metastases. METHODS: Electrochemotherapy with bleomycin was combined with open liver resection and performed with linear or hexagonal needle electrodes according to an individualized pretreatment plan...
June 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28618075/surgical-treatment-for-advanced-hepatocellular-carcinoma-with-portal-vein-tumor-thrombus
#5
REVIEW
Kazuhiko Sakamoto, Hiroaki Nagano
The Barcelona Clinic Liver Cancer (BCLC) staging system recommends administration of a tyrosine kinase inhibitor (sorafenib) as standard therapy in advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). Sorafenib has been shown to prolong median overall survival (OS) by about 3 months in advanced HCC patients with PVTT (8.1 vs 4.9 months). However, its clinical effectiveness is still controversial and standard treatment with sorafenib is not established in Japan. Surgical resection is considered as a potentially curative treatment and provides an acceptable outcome for carefully selected patients...
June 15, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28612019/thermal-ablation-in-the-management-of-colorectal-cancer-patients-with-oligometastatic-liver-disease
#6
REVIEW
Elena Nadia Petre, Constantinos Sofocleous
BACKGROUND: Surgical resection of limited colorectal liver disease improves long-term survival and can be curative in a subset of selected cases. Image-guided percutaneous ablation therapies have emerged as safe and effective alternative options for selected patients with unresectable colorectal liver metastases (CLM) that can be ablated with margins. Ablation causes focal destruction of tissue and has increasingly been shown to provide durable eradication of tumors. METHODS: A selective review of literature was conducted in PubMed, focusing on recent studies reporting on the safety, efficacy, and long-term outcomes of percutaneous ablation modalities in the treatment of CLM...
March 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28612018/treatment-options-in-oligometastatic-disease-stereotactic-body-radiation-therapy-focus-on-colorectal-cancer
#7
REVIEW
Aaron T Wild, Yoshiya Yamada
BACKGROUND: Improvements in systemic therapy for metastatic colorectal cancer (CRC) have markedly extended survival, rendering local control of metastases to critical organs of increasing importance, especially in the oligometastatic setting where the disease may not yet have acquired the ability to widely disseminate. While surgical resection remains the gold standard for oligometastases in many organs, stereotactic body radiation therapy (SBRT) presents a non-invasive alternative for achieving local control...
March 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28612016/oligometastatic-disease-in-the-peritoneal-space-with-gastrointestinal-cancer
#8
REVIEW
Beate Rau, Andreas Brandl, Andreas Pascher, Wieland Raue, Paul Sugarbaker
OBJECTIVES: Treatment options for patients with gastrointestinal cancer and oligometastastic disease remain the domain of the medical oncologist. However, in selected cases, attempts to remove or destroy the tumor burden seem appropriate. BACKGROUND DATA: During the last decade, the treatment of localized and isolated tumor nodules, such as lung, liver or peritoneal metastasis, has changed. Previously, these patients with metastatic disease only received palliative chemotherapy...
March 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28612013/oligometastatic-disease-in-colorectal-cancer-how-to-proceed
#9
REVIEW
Felix Aigner, Johann Pratschke, Moritz Schmelzle
BACKGROUND: Oligometastatic disease in colorectal cancer may affect the liver, lung, and peritoneum. This review mainly focuses on colorectal liver metastases (CRLM) and highlights recommendations and therapeutic strategies drawn from the current literature and consensus conferences. The following data address a paradigm shift in surgical approaches to CRLM, pushing the limits of multimodal treatment concepts. METHODS: A systematic review of the relevant literature on multimodal treatment strategies for synchronous and metachronous CRLM is presented...
March 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28611526/different-techniques-for-harvesting-grafts-for-living-donor-liver-transplantation-a-systematic-review-and-meta-analysis
#10
Hui Li, Jun-Bin Zhang, Xiao-Long Chen, Lei Fan, Li Wang, Shi-Hui Li, Qiao-Lan Zheng, Xiao-Ming Wang, Yang Yang, Gui-Hua Chen, Gen-Shu Wang
AIM: To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation. METHODS: PubMed, Web of Science, EMBASE, and the Cochrane Library were searched comprehensively for studies comparing MILDH with conventional living donor hepatectomy (CLDH). Intraoperative and postoperative outcomes (operative time, estimated blood loss, postoperative liver function, length of hospital stay, analgesia use, complications, and survival rate) were analyzed in donors and recipients...
May 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28609188/subtraction-images-of-gadoxetic-acid-enhanced-mri-effect-on-the-diagnostic-performance-for-focal-hepatic-lesions-in-patients-at-risk-for-hepatocellular-carcinoma
#11
Sang Hyun Choi, So Yeon Kim, Seung Soo Lee, Ju Hyun Shim, Jae Ho Byun, Seunghee Baek, Moon-Gyu Lee
OBJECTIVE: The purpose of this study is to evaluate the effect of subtraction images of gadoxetic acid-enhanced MRI on the image interpretation of focal hepatic lesions in patients at risk for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: We retrospectively analyzed 255 malignant nodules from 233 patients with chronic hepatitis or liver cirrhosis (187 men and 46 women; mean age, 55.2 years) who underwent preoperative gadoxetic acid-enhanced MRI and surgical resection...
June 13, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28604841/evaluation-of-potential-changes-in-liver-and-lung-tissue-of-rats-in-an-ischemia-reperfusion-injury-model-modified-pringle-maneuver
#12
Silvio Henrique Freitas, Renata G S Dória, Rachel S Bueno, William B Rocha, Jair R E Filho, Julieta R E Moraes, Atanásio Serafin Vidane, Carlos E Ambrósio
In surgical procedures involving the liver, such as transplantation, resection, and trauma, a temporary occlusion of hepatic vessels may be required. This study was designed to analyze the lesions promoted by ischemia and reperfusion injury of the hepatic pedicle, in the liver and lung, using histopathological and immunohistochemical techniques. In total, 39 Wistar rats were divided into four groups: control group (C n = 3) and ischemia groups subjected to 10, 20, and 30 minutes of hepatic pedicle clamping (I10, n = 12; I20, n = 12; I30, n = 12)...
2017: PloS One
https://www.readbyqxmd.com/read/28599872/hepatotoxicity-following-systemic-therapy-for-colorectal-liver-metastases-and-the-impact-of-chemotherapy-associated-liver-injury-on-outcomes-after-curative-liver-resection
#13
REVIEW
G Duwe, S Knitter, S Pesthy, A S Beierle, M Bahra, M Schmelzle, R B Schmuck, P Lohneis, N Raschzok, R Öllinger, M Sinn, B Struecker, I M Sauer, J Pratschke, A Andreou
Patients with colorectal liver metastases (CLM) have remarkably benefited from the advances in medical multimodal treatment and surgical techniques over the last two decades leading to significant improvements in long-term survival. More patients are currently undergoing liver resection following neoadjuvant chemotherapy, which has been increasingly established within the framework of curative-indented treatment strategies. However, the use of several cytotoxic agents has been linked to specific liver injuries that not only impair the ability of liver tissue to regenerate but also decrease long-term survival...
May 18, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28567528/portal-vein-embolization-in-extended-liver-resection
#14
REVIEW
Nisha Narula, Thomas A Aloia
BACKGROUND: Liver resection of benign, primary, and metastatic tumors is challenging and places patients at risk of postoperative liver insufficiency. This risk is largely dependent on the volume and function of the future liver remnant (FLR). It is, therefore, critical that hepatobiliary surgeons are well versed in the measurement of liver volume and function, as well as various techniques for preoperative liver volume augmentation. PURPOSE: This comprehensive review of portal vein embolization (PVE) begins with an overview of FLR measurement and progresses to patient factors to consider when choosing PVE and assessment of hypertrophy...
May 31, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28567071/associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-a-surgical-technique-for-liver-resections
#15
Behnam Sanei, Saba Sheikhbahaei, Mohammad Hossein Sanei, Amin Bahreini, Hamid Reza Jafari
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel surgical technique liver resection in traditionally nonresectable primary intrahepatic tumors or colorectal liver metastases. MATERIALS AND METHODS: From June 2013 to March 2014, patients with primary tumor of liver or colorectal tumors with liver metastasis were selected to evaluate whether they met the initial criteria for ALPPS procedure. RESULTS: Nine patients enrolled in the study with primary diagnoses of colon and rectosigmoid cancer, carcinoid tumor, gastrointestinal stromal tumor of small intestine, hepatocellular carcinoma, and pancreatic neuroendocrine tumor (PNET)...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28560599/computed-tomography-image-texture-a-noninvasive-prognostic-marker-of-hepatic-recurrence-after-hepatectomy-for-metastatic-colorectal-cancer
#16
Amber L Simpson, Alexandre Doussot, John M Creasy, Lauryn B Adams, Peter J Allen, Ronald P DeMatteo, Mithat Gönen, Nancy E Kemeny, T Peter Kingham, Jinru Shia, William R Jarnagin, Richard K G Do, Michael I D'Angelica
BACKGROUND: Recurrence after resection of colorectal liver metastases (CRLMs) occurs in up to 75% of patients. Preoperative prediction of hepatic recurrence may inform therapeutic strategies at the time of initial resection. Texture analysis (TA) is an established technique that quantifies pixel intensity variations (heterogeneity) on cross-sectional imaging. We hypothesized that tumoral and parenchymal changes that are predictive of overall survival (OS) and recurrence in the future liver remnant (FLR) can be detected using TA on preoperative computed tomography (CT) images...
May 30, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28557354/modeling-liver-electrical-conductivity-during-hypertonic-injection
#17
Quim Castellví, Patricia Sánchez-Velázquez, Xavier Moll, Enrique Berjano, Anna Andaluz, Fernando Burdío, Bart Bijnens, Antoni Ivorra
Metastases in the liver frequently grow as scattered tumor nodules which neither can be removed by surgical resection nor focally ablated. Previously, we have proposed a novel technique based on irreversible electroporation which may be able to simultaneously treat all nodules in the liver while sparing healthy tissue. The proposed technique requires increasing the electrical conductivity of healthy liver by injecting a hypersaline solution through the portal vein. Aiming to assess the capability of increasing the global conductivity of the liver by means of hypersaline fluids, here it is presented a mathematical model which estimates the NaCl distribution within the liver and the resulting conductivity change...
May 30, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28555378/-a-59-year-old-woman-with-upper-abdominal-pain-and-fever
#18
J B M Christ, A Tannapfel, G Kukuk, K Schlottmann, C Straßburg, A Schneidewind
A 59-year-old woman suffered from fever and upper abdominal pain. The computed tomography (CT) scan revealed a liver lesion. Conventional imaging techniques (CT, magnetic resonance imaging, contrast-enhanced ultrasonography) did not allow for a consistent diagnosis. Fine needle biopsy of the liver lesion was performed. Histologically, fibrotic inflammation was found and an inflammatory pseudotumor (IPT) diagnosed. Despite treatment with steroids and antibiotics, the size of the IPT increased; thus, surgical resection was necessary...
May 29, 2017: Der Internist
https://www.readbyqxmd.com/read/28549521/techniques-of-parenchyma-sparing-hepatectomy-for-the-treatment-of-tumors-involving-the-hepatocaval-confluence-a%C3%A2-reliable-way-to-assure-an-adequate-future-liver-remnant-volume
#19
Lucio Urbani, Piero Colombatto, Riccardo Balestri, Gabriella Licitra, Chiara Leoni, Francesco Forfori, Gianluca Masi, Piero Boraschi, Maura Castagna, Piero Buccianti
BACKGROUND: Parenchyma-sparing hepatectomy techniques allow a lesser volume resection (<3 adjacent segments) for tumors involving the hepatic veins at the hepatocaval confluence, assuring adequate volume of the future liver remnant. We report the ability to perform parenchyma-sparing hepatectomy as planned from the preoperative imaging and the type of vascular intervention used to preserve hepatic outflow. METHODS: We analyzed 60 consecutive parenchyma-sparing hepatectomies in 54 patients for 7 primary and 53 metastatic tumors (48 colorectal), located in segments I, VII, VIII, or IVa and involving the hepatocaval confluence...
May 24, 2017: Surgery
https://www.readbyqxmd.com/read/28547740/biliary-duodenal-anastomosis-using-magnetic-compression-following-massive-resection-of-small-intestine-due-to-strangulated-ileus-after-living-donor-liver-transplantation-a-case-report
#20
Ryusuke Saito, Hiroyuki Tahara, Seiichi Shimizu, Masahiro Ohira, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Hideki Ohdan
BACKGROUND: Despite the improvements of surgical techniques and postoperative management of patients with liver transplantation, biliary complications are one of the most common and important adverse events. We present a first case of choledochoduodenostomy using magnetic compression following a massive resection of the small intestine due to strangulated ileus after living donor liver transplantation. CASE PRESENTATION: The 54-year-old female patient had end-stage liver disease, secondary to liver cirrhosis, due to primary sclerosing cholangitis with ulcerative colitis...
December 2017: Surgical Case Reports
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