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Liver resection technique

Fernanda Granato, Andre C Felicio, Lilian Yuri Itaya Yamaga, Solange Amorim Nogueira, Taise Vitor
The liver is the organ most commonly affected by colorectal cancer metastasis. Currently, liver resection is the treatment of choice, but in cases where it is not possible, intensity-modulated radiation therapy is an alternative. We report the case of a 57-year-old woman whose colorectal carcinoma metastasized to the liver. She was referred for implantation of fiducial markers for intensity-modulated radiation therapy planning. PET-CT stands out as an additional tool for distinguishing metabolically active tumor tissue from other tissues, ensuring effective introduction of percutaneous fiducial markers, especially in cases where use of conventional imaging techniques is limited...
October 21, 2016: Clinical Nuclear Medicine
L Rodríguez Caraballo, J Gómez-Chacón Villalban, P Rodríguez Iglesias, L Mangas Álvarez, A Marco Macián
OBJECTIVE: To describe our experience in the use of the guided hook wire placement to undergo thoracoscopic resection of pulmonary metastases in children. MATERIAL AND METHODS: We conducted a retrospective review, between January 2008 and December 2014 of the patients that were diagnosed with pulmonary metastases by image and who underwent a thoracoscopic metastasectomy. Patients in whom a CT- guided hook was done before the surgery were included. RESULTS: Eleven procedures were done in ten patients with a median age of 10 years (range 2-16 years)...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Daniel Cherqui, Go Wakabayashi, David A Geller, Joseph F Buell, Ho-Seong Han, Olivier Soubrane, Nicholas O'Rourke
In this article, we present the rationale for creating a new society aiming at organizing laparoscopic liver surgery. It has been named International Laparoscopic Liver Society (ILLS). Its main mission is to facilitate the diffusion and education of laparoscopic liver resection for meaningful improvements in patient care. This will include organization of a biannual congress dedicated to laparoscopic liver resection, coordination of international registries, helping in the education of surgeons wishing to learn these techniques including travel grants, provide a website serving as a forum supporting collaboration between surgeons interested in the advancement of laparoscopic liver resection techniques (http://www...
October 21, 2016: Journal of Hepato-biliary-pancreatic Sciences
Youlong Wang, Wenbin Ji, Xi Zhang, Jingwang Tan
BACKGROUND: Liver resection or enucleation has been the basic treatment for liver hemangioma. However, there were few reports about laparoscopic surgery (LS) of hemangioma. The intention of this study is to explore the indication and efficacy of LS for laparoscopic hepatectomy (LH) and develop an opinion of these modern developments. PATIENTS AND METHODS: Forty-four patients with LH underwent LS, with hemihepatic vascular occlusion (HVO group n = 24) or modified vascular occlusion (MVO group n = 20), and were retrospectively reviewed, including patients' demography, surgical technique, tumor size and location, blood loss, operation time, complications, modes of hepatic vascular occlusion and changes in postoperative liver function, and the difference in patients demography and operative outcome between HVO and MVO groups were compared as well...
October 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Le Xiao, Jian-Wei Li, Shu-Guo Zheng
BACKGROUND: The reported protocol was difficult to expose the hepatic veins for laparoscopic anatomical hepatectomy of segments VII and VIII. We introduce a new, convenient, applicable approach with the hepatic vein exposed from the head side. METHODS: This study included 10 patients who underwent laparoscopic liver resection for HCC in the segments VII and VIII between October, 2014 and November, 2015. Their perioperative course and operative techniques were retrospectively evaluated...
October 14, 2016: Journal of Surgical Oncology
Michiro Susa, Kazutaka Kikuta, Robert Nakayama, Kazumasa Nishimoto, Keisuke Horiuchi, Sota Oguro, Masanori Inoue, Hideki Yashiro, Seishi Nakatsuka, Masaya Nakamura, Morio Matsumoto, Kazuhiro Chiba, Hideo Morioka
BACKGROUND: Historically, local control of recurrent sarcomas has been limited to radiotherapy when surgical re-resection is not feasible. For metastatic carcinomas to the bone or soft tissue, radiotherapy and some interventional radiology treatment along with other systemic therapies have been widely advocated due to the possibility of disseminated disease. These techniques are effective in alleviating pain and achieving local control for some tumor types, but it has not been effective for prolonged local control of most tumors...
October 13, 2016: BMC Cancer
Janelle Rekman, Christopher Wherrett, Sean Bennett, Miso Gostimir, Sara Saeed, Kristina Lemon, Richard Mimeault, Fady K Balaa, Guillaume Martel
BACKGROUND: Liver resection can be associated with significant blood loss and transfusion. Whole blood phlebotomy is an under-reported technique, distinct from acute normovolemic hemodilution, the goal of which is to minimize blood loss in liver operation. This work sought to report on its safety and feasibility and to describe technical considerations. METHODS: Consecutive patients who had an elective liver resection and concurrent phlebotomy between 2013 and 2016 were examined prospectively...
October 3, 2016: Surgery
Georgios C Sotiropoulos, Nikolaos Machairas, Paraskevas Stamopoulos, Ioannis D Kostakis, Dimitrios Dimitroulis, Dimitrios Mantas, Gregory Kouraklis
BACKGROUND: Liver resection represents the treatment of choice for a small proportion of patients with hepatocellular carcinoma (HCC), amenable to surgery. The remarkable evolution in surgical techniques during the last decades introduced laparoscopic hepatectomy in the operative management of HCC, even in the presence of liver cirrhosis. No comparative study on laparoscopic or open liver resection for HCC has been conducted in Greece yet. METHODS: Patients undergoing liver resection for HCC by one senior hepatobiliary surgeon in our Institution during the period 11/2011-02/2016 were prospectively sampled and retrospectively analyzed for the purposes of this study...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Fan-Ying Meng, Li Liu, Jun Liu, Chun-You Li, Jian-Ping Wang, Feng-Hui Yang, Zhi-Shui Chen, Ping Zhou
AIM: To analyze retrospectively a 5-year experience of human hepatocyte isolation from resected liver tissues with benign disease. METHODS: We established a method of modified four-step retrograde perfusion to isolate primary human hepatocytes. Samples were collected from the resected livers of patients with intrahepatic duct calculi (n = 7) and liver hemangioma (n = 17). Only the samples weighing ≥ 15 g were considered suitable for hepatocyte isolation. By using the standard trypan blue exclusion technique, hepatocyte viability and yield were immediately determined after isolation...
September 28, 2016: World Journal of Gastroenterology: WJG
Chao-Wei Lee, Hsin-I Tsai, Chang-Mu Sung, Chun-Wei Chen, Shu-Wei Huang, Wen-Juei Jeng, Tsung-Han Wu, Kun-Ming Chan, Ming-Chin Yu, Wei-Chen Lee, Miin-Fu Chen
Despite advances in surgical technique and medical care, liver resection for hepatocellular carcinoma (HCC) remains a high-risk major operation. The present study evaluated the risk factors for early mortality after hepatectomy.We retrospectively reviewed records of patients undergoing liver resection for HCC between 1983 and 2015. A point score (Risk Assessment for early Mortality (RAM) score) for hepatectomy was developed based on multivariate analyses.Three hundred eighty-three patients (11.3%) expired within 6 months after the operation...
September 2016: Medicine (Baltimore)
Sung Hoon Choi, Gi Hong Choi, Dai Hoon Han, Sung Won Kwon, Jin Sub Choi
BACKGROUND: Major hurdles for laparoscopic right hepatectomy (LapRH) include difficulties in (1) mobilization and (2) applying hanging maneuver and (3) lack of experienced assistants. We discuss the protocolization of lapRH, introducing our simplified technique. METHODS: The procedure was disassembled into six steps: (1) curtailed mobilization of the right liver so as to align the resection plane with the laparoscopic camera view, (2) inflow vascular control, (3) setting up the parenchymal resection applying the rubber band retraction method, (4) parenchymal resection approaching the caudate lobe, (5) a lifting-up maneuver using a laparoscopic grasper or retractor instead of the hanging maneuver, and (6) completion of resection dividing the caudate lobe, right hepatic vein, and remaining ligament...
September 28, 2016: Annals of Surgical Oncology
L X Cai, S L He, F Q Wei, Y C Yu, X J Cai
Objective: The aim was to explore the strategy and clinical value of laparoscopic transection of median hepatic fissure (MHF) in difficult laparoscopic liver resections. Methods: First the MHF was located and marked, then the transection plane of the MHF was set. Next, the laparoscopic Multifuctional Operative Dissector (LPMOD) and the technique of curettage and aspiration were utilized to transect the liver beginning from the middle portion of the gallbladder fossa, in a caudal-to-cranial and anterior-to-posterior direction, until the clear exposure of the anterior surface of the intrahepatic inferior vena cava...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Petros Ypsilantis, Constantinos Simopoulos
BACKGROUND: Laparoscopic partial hepatectomy is an increasingly applied technique in the treatment of liver tumors and in living donor transplantation. There is a need for establishing an animal model that would facilitate experimental research on the technique. The aim of the present study was to describe a safe and efficient laparoscopic technique of 70% partial hepatectomy in the rat. MATERIALS AND METHODS: Twenty-four male Wistar rats underwent either laparoscopic (group LAP-HEP) or open resection of the median and left lateral hepatic lobes (group HEP)...
October 2016: Journal of Surgical Research
Angelo Pierangelo, David Fuks, Pierre Validire, Ali Benali, Brice Gayet
OBJECTIVES: Probe-based confocal laser endomicroscopy (pCLE) is a promising new imaging technique enabling in-vivo analysis of tissues at the cellular level, in real time. The aim of the present study was to prospectively evaluate the feasibility and accuracy of indocyanine green-aided pCLE for the diagnosis of malignant liver nodules. PATIENTS AND METHODS: From October 2014 to July 2015, liver specimens from 30 consecutive patients were analyzed ex vivo using pCLE directly after resection, with indocyanine green as contrast agent...
September 22, 2016: European Journal of Gastroenterology & Hepatology
Jan H Nilsson, Nina Reistad, Hannes Brange, Carl-Fredrik Öberg, Christian Sturesson
BACKGROUND: Liver parenchymal injuries such as steatosis, steatohepatitis, fibrosis, and sinusoidal obstruction syndrome can lead to increased morbidity and liver failure after liver resection. Diffuse reflectance spectroscopy (DRS) is an optical measuring method that is fast, convenient, and established. DRS has previously been used on the liver with an invasive technique consisting of a needle that is inserted into the parenchyma. We developed a DRS system with a hand-held probe that is applied to the liver surface...
September 23, 2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Yasumasa Takii, Satoshi Maruyama, Hitoshi Nogami
Surgical resection is the only curative treatment modality for colorectal cancer limited locally. Evidence for the kind of resection procedure that is effective for improving prognosis is insufficient. Prognosis improvement is expected with the no-touch isolation technique (NTIT), making it the most important resection procedure. We are conducting a multicenter randomized controlled trial (RCT) to confirm the efficacy of NTIT in patients with colorectal cancer. The present review serves as a preface to our trial, as it focuses on basic and clinical studies that support the efficacy of NTIT...
August 27, 2016: World Journal of Gastrointestinal Surgery
Stefano Di Sandro, Andrea Lauterio, Alessandro Giacomoni, Giacomo Concone, Iacopo Mangoni, Plamen Mihaylov, Luciano De Carlis
Although the application of robotic-assisted techniques is widespread in urology, gynecology, and in thoracic, general and cardiac surgery, few studies have assessed the feasibility and advantages of robotic-assisted surgery for liver tumors. In particular, no authors have assessed the benefits of the application of totally robotic LR (TR-LR) to the specific setting of HCC on liver cirrhosis. Between March and December 2011, 18 TR-LRs were performed at our institute. The operation was performed on account of a single nodule of HCC associated with liver cirrhosis in 10 (56 %) patients, who were included in the study...
December 2014: Journal of Robotic Surgery
Kuniya Tanaka, Yutaro Kikuchi, Daisuke Kawaguchi, Takashi Murakami, Yukihiko Hiroshima, Kenichi Matsuo
OBJECTIVE: We describe a modified procedure associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) including portal pedicle preservation during parenchymal division, thus avoiding necrosis. BACKGROUND: Although ALPPS recently has been advocated for treating advanced liver tumors, sepsis originating from the ischemic area produced by parenchymal division increases mortality, accounting for one-third of postoperative deaths. METHODS: Our procedure differs from the original ALPPS technique by sparing portal pedicles at the transection plane, thus maintaining blood supply...
September 8, 2016: Annals of Surgery
Erik Tanis, Danny J Evers, Jarich W Spliethoff, Vishnu V Pully, Koert Kuhlmann, Frits van Coevorden, Benno H W Hendriks, Joyce Sanders, Warner Prevoo, Theo J M Ruers
BACKGROUND AND OBJECTIVE: Over the last decade, an increasing effort has been put towards the implementation of optical guidance techniques to aid surgeons during cancer surgery. Diffuse reflectance spectroscopy (DRS) and fluorescence spectroscopy (FS) are two of these new techniques. The objective of this study is to investigate whether in vivo optical spectroscopy is able to accurately discriminate colorectal liver metastases (CRLM) from normal liver tissue in vivo. MATERIALS AND METHODS: DRS and FS were incorporated at the tip of a needle and were used for in vivo tissue differentiation during resection of CRLM...
September 8, 2016: Lasers in Surgery and Medicine
I R Elizalde Apestegui, C Saldaña Dueñas, S Goñi Esarte, C Prieto Martínez, B Sangro Gómez-Acebo, J M Zozaya Urmeneta
BACKGROUND: Hepatocellular carcinoma generally arises in a cirrhotic liver. The aim of screening is to improve survival. The aims of our study are to determine the characteristics and evolution of hepatocellular carcinoma and the effect of screening on survival, in clinical practice in Navarre. METHODS: Prospective and retrospective study of 111 patients diagnosed with hepatocellular carcinoma in public hospitals in Navarre between January 2009 and January 2015...
2016: Anales del Sistema Sanitario de Navarra
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