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Two stage hepatectomy

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https://www.readbyqxmd.com/read/28990002/two-cases-of-alpps-procedure-simultaneous-alpps-and-colorectal-resection-and-alpps-procedure-for-hepatic-malignancy-larger-than-15-centimeter
#1
Young Il Choi, Hyung Hwan Moon, Dong Hoon Shin
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been introduced as a new surgical technique to increase future liver remnant in patients with marginal liver volume contemplating major liver resection. We herein present two cases. Case 1: a 68-year-old male patient with colorectal liver metastasis was referred to our department. The future liver remnant (FLR) was 22%. We performed first-stage ALPPS and colorectal surgery concurrently and second stage operation was performed 8 days later...
August 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28917644/alpps-as-a-salvage-procedure-after-insufficient-future-liver-remnant-hypertrophy-following-portal-vein-occlusion
#2
Marcelo Enne, Erik Schadde, Bergthór Björnsson, Roberto Hernandez Alejandro, Klaus Steinbruck, Eduardo Viana, Ricardo Robles Campos, Massimo Malago, Pierre-Alain Clavien, Eduardo De Santibanes, Brice Gayet
BACKGROUND: A minimum future liver remnant (FLR) of 30% is required to avoid post hepatectomy liver failure (PHLF). Portal vein occlusion (PVO) is the main strategy to induce hypertrophy of the FLR, but some patients will not reach sufficient FLR hypertrophy to enable resection. Recently ALPPS has emerged as a "Salvage Procedure" for PVO failure. The aim of this study was to report the short term outcomes of ALPPS following PVO failure. METHODS: A retrospective analysis of patients enrolled within the international ALPPS Registry between October 2012 and November 2015 (NCT01924741) was performed...
September 13, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28902669/alpps-improves-resectability-compared-with-conventional-two-stage-hepatectomy-in-patients-with-advanced-colorectal-liver-metastasis-results-from-a-scandinavian-multicenter-randomized-controlled-trial-ligro-trial
#3
Per Sandström, Bård I Røsok, Ernesto Sparrelid, Peter N Larsen, Anna L Larsson, Gert Lindell, Nicolai A Schultz, Bjorn A Bjørnbeth, Bengt Isaksson, Magnus Rizell, Bergthor Björnsson
OBJECTIVE: The aim of the study was to evaluate if associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) could increase resection rates (RRs) compared with two-stage hepatectomy (TSH) in a randomized controlled trial (RCT). BACKGROUND: Radical liver metastasis resection offers the only chance of a cure for patients with metastatic colorectal cancer. Patients with colorectal liver metastasis (CRLM) and an insufficient future liver remnant (FLR) volume are traditionally treated with chemotherapy with portal vein embolization or ligation followed by hepatectomy (TSH)...
September 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28890830/cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-combined-with-two-stage-hepatectomy-for-multiple-and-bilobar-desmoplastic-small-round-cell-tumor-liver-metastases
#4
Alejandro Cracco, Mayank Roy, Conrad H Simpfendorfer
Desmoplastic small round cell tumor (DSRCT) is a rare mesenchymal tumor usually affecting young patients. Local dissemination is common, and liver is the most common site for extraperitoneal metastases. Multimodal management has been shown to be the most effective treatment. Some authors consider liver metastases especially bi-lobar disease as a contraindication for surgical resection. We present a case of a DSRCT with bi-lobar metastases in an adult patient who underwent multi-modal management along with hepatectomy...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28875240/potential-predictive-factors-for-microvascular-invasion-in-hepatocellular-carcinoma-classified-within-the-milan-criteria
#5
Satoru Imura, Hiroki Teraoku, Masato Yoshikawa, Daichi Ishikawa, Shinichiro Yamada, Yu Saito, Shuichi Iwahashi, Tetsuya Ikemoto, Yuji Morine, Mitsuo Shimada
BACKGROUND: Microvascular invasion (mvi) is an important risk factor for recurrent hepatocellular carcinoma (HCC), even after curative liver resection or orthotopic liver transplantation. However, mvi is difficult to detect preoperatively. The aim of this study was to clarify the risk factors of postoperative recurrence and investigate predictive factors of mvi before hepatectomy for HCC classified within the Milan criteria. METHODS: One hundred fifty-nine patients with hepatocellular carcinoma (HCC) classified within the Milan criteria, who underwent hepatectomy, were enrolled in this study...
September 5, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28820745/impact-of-surgical-treatment-for-recurrence-after-2-stage-hepatectomy-for-colorectal-liver-metastases-on-patient-outcome
#6
Katsunori Imai, Carlos Castro Benitez, Marc-Antoine Allard, Eric Vibert, Antonio Sa Cunha, Daniel Cherqui, Denis Castaing, Henri Bismuth, Hideo Baba, René Adam
OBJECTIVE: To evaluate the impact of repeat surgery for recurrence on the long-term survival after 2-stage hepatectomy (TSH) for extensive colorectal liver metastases (CRLM). BACKGROUND: Although TSH is now deemed effective for selected patients with extensive bilobar CRLM, disease recurrence after TSH is very frequent because of the extensive tumor load. METHODS: Among a total cohort of 1235 patients who underwent hepatectomy for CRLM between 1992 and 2012, 139 with extensive bilobar CRLM were scheduled for TSH...
August 17, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28816980/two-stage-hepatectomy-for-multiple-giant-alveolar-echinococcosis
#7
Hao-De Shen, Ke-Fei Chen, Bo Li, Han-Zhi Zhang, Kang-Ming Yang, Yin Chen, Jia-Xin Li, Zhe-Yu Chen, Ta Meng, Zhi Ma, Hong-Zhi Li
Alveolar echinococcosis is a chronically progressive and potentially fatal disease. Patients with multiple giant alveolar echinococcosis have a poor prognosis when radical resection cannot be achieved, but curative resection can be limited by low future remnant liver volumes. In these cases, 2-stage liver resection may be a better choice: after a first-stage hepatectomy with partial resection, liver regeneration is allowed in the residual liver before proceeding to the second-stage hepatectomy. In this study, we therefore retrospectively reviewed and evaluated the safety and feasibility of two-stage hepatectomy in patients with multiple giant alveolar echinococcosis...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28798996/operative-results-and-oncologic-outcomes-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-versus-two-stage-hepatectomy-tsh-in-patients-with-unresectable-colorectal-liver-metastases-a-systematic-review-and-meta-analysis
#8
REVIEW
Dimitrios Moris, Sean Ronnekleiv-Kelly, Ioannis D Kostakis, Diamantis I Tsilimigras, Eliza W Beal, Alexandros Papalampros, Dimitrios Dimitroulis, Evangelos Felekouras, Timothy M Pawlik
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently emerged as a treatment choice for patients with colorectal liver metastases (CLM) and inadequate future liver remnant (FLR). The aim of this study was to define the results of ALPPS compared with two-stage hepatectomy (TSH) for patients with CLM. MATERIALS AND METHODS: A meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines...
August 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28774330/the-paradigm-of-tumor-shrinkage-and-rapid-liver-remnant-hypertrophy-for-conversion-of-initially-unresectable-colorectal-liver-metastasis-a-case-report-and-literature-review
#9
Nan Xiao, Kailin Yu, Shaojun Yu, Jianjun Wu, Jian Wang, Siyang Shan, Shuchun Zheng, Liuhong Wang, Jianwei Wang, Shuyou Peng
BACKGROUND: For colorectal liver metastasis (CRLM) patients, hepatic resection is currently the sole cure offering the chance of long-term survival. Tumor shrinkage and planned liver remnant hypertrophy are the two key strategies for conversion of initially unresectable CRLM. First conducted in 2012, associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows rapid liver growth. As a means to induce hypertrophy, portal vein embolization (PVE) has been widely applied before extending hepatectomy...
August 3, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28767916/transection-of-the-hepatic-parenchyma-associated-or-not-with-the-contralateral-portal-vein-branch-ligature-and-its-effect-in-liver-regeneration
#10
Henrique de Aguiar Wiederkehr, Julio Cesar Wiederkehr, Luiz Martins Collaço, Eros Luiz de Sousa, Paolo Salvalaggio, Caroline Aragão de Carvalho, Barbara de Aguiar Wiederkehr, Camila Aparecida Moraes Marques, Francielle França da Rosa, Felipe de Negreiros Nanni, Taíse Fuchs
Objective: To analyze the influence of portal vein ligation in hepatic regeneration by immunohistochemical criteria. Methods: Ten pigs divided into two groups of five animals underwent hepatectomy in two stages, and the groups were differentiated by ligation or not of the left portal vein tributary, which is responsible for vascularization of the left lateral and medial lobes of the pig liver. Five days after the procedure, the animals underwent liver biopsies for further analysis of histological and immunohistochemical with marker Ki67...
April 2017: Einstein
https://www.readbyqxmd.com/read/28765703/extreme-liver-resections-with-preservation-of-segment-4-only
#11
Silvio Marcio Pegoraro Balzan, Vinícius Grando Gava, Marcelo Arbo Magalhães, Marcelo Luiz Dotto
AIM: To evaluate safety and outcomes of a new technique for extreme hepatic resections with preservation of segment 4 only. METHODS: The new method of extreme liver resection consists of a two-stage hepatectomy. The first stage involves a right hepatectomy with middle hepatic vein preservation and induction of left lobe congestion; the second stage involves a left lobectomy. Thus, the remnant liver is represented by the segment 4 only (with or without segment 1, ± S1)...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28758812/combination-with-ck19-might-increase-the-prognostic-power-of-hep-par-1-in-hepatocellular-carcinoma-after-curative-resection
#12
Ye Jin, Zhi-Yong Liang, Wei-Xun Zhou, Li Zhou
PURPOSE: Hepatocyte Paraffin 1 (Hep Par 1) and cytokeratin 19 (CK19) were shown to be associated with post-surgical prognosis of hepatocellular carcinoma (HCC). However, further validation might be needed. Besides, their combined evaluation has not been reported. The present study was designed to address the issues. MATERIALS AND METHODS: Expressions of Hep Par 1 and CK19 were detected using tissue microarray-based immunohistochemical staining in 79 patients with HCC underwent curative hepatectomy...
July 31, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28734130/right-lobe-living-donors-ages-55-and-older-in-liver-transplantation
#13
Seong Hoon Kim, Eung Chang Lee, Jae Ryong Shim, Sang Jae Park
Insufficient is the evidence for safe use of elderly donors in adult-to-adult living donor liver transplantation (LDLT). The aim of this study was to evaluate the outcomes of right lobe LDLT by donor age (≥55 vs. <55 years). All living donors who underwent right hepatectomy at the authors' institution between March 2008 and December 2015 were divided into 2 groups: group A with an age ≥ 55 and group B with an age < 55. The selection criteria for elderly donor were preservation of middle hepatic vein, remnant liver volume ≥30%, and no or mild fatty liver...
July 22, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28728985/adjuvant-hepatic-arterial-infusion-chemotherapy-is-beneficial-for-selective-patients-with-hepatocellular-carcinoma-undergoing-surgical-treatment
#14
Jui-Hu Hsiao, Cheng-Chung Tsai, Tsung-Jung Liang, Chia-Ling Chiang, Huei-Lung Liang, I-Shu Chen, Yu-Chia Chen, Po-Ming Chang, Nan-Hua Chou, Being-Whey Wang
BACKGROUND: Recurrence rate after curative surgical resection of Hepatocellular carcinoma (HCC) remains high. Postoperative hepatic arterial infusion chemotherapy (HAIC) has been suggested to improve survival. This study is to investigate the efficacy of HAIC in the patients with poor tumor factors such as vascular invasion or multiplicity. METHODS: From 2006 to 2014, 221 patients with HCC undergoing hepatectomy and pathologically staged as ≧ T2 (American Joint Committee on Cancer TNM staging system, 7th edition) were included...
July 17, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28676605/-ii-two-stage-hepatectomy
#15
Hajime Imamura, Susumu Eguchi
No abstract text is available yet for this article.
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28676383/hepatectomy-after-down-staging-of-hepatocellular-carcinoma-with-portal-vein-tumor-thrombus-using-chemoradiotherapy-a-retrospective-cohort-study
#16
Michinori Hamaoka, Tsuyoshi Kobayashi, Shintaro Kuroda, Hiroshi Iwako, Sho Okimoto, Tomoki Kimura, Hiroshi Aikata, Yasushi Nagata, Kazuaki Chayama, Hideki Ohdan
BACKGROUND: This study evaluates the survival benefit and safety of hepatectomy after down-staging by 3-dimensional conformal radiation therapy (3D-CRT) for major portal vein tumor thrombus (PVTT) combined with hepatic arterial infusion chemotherapy (HAIC) for advanced hepatocellular carcinoma (HCC). METHODS: Fifty-two patients with unresectable advanced HCC treated with HAIC combined with 3D-CRT for PVTT, from January 2002 to March 2015, were analyzed in this retrospective study...
July 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28675369/good-to-know-the-alpps-procedure-embracing-a-new-technique
#17
George-Andrei Popescu, Sorin Tiberiu Alexandrescu, Razvan Tudor Grigorie, Luminiţa Stoica, Cristian Alexandru Apavaloaie, Doina Hrehoreţ
BACKGROUND: Hepatic resection is the only potentially curative treatment for primary liver tumors and hepatic metastases. The most frightening postoperative complication of extensive hepatectomies is liver failure due to insufficient future liver remnant (FLR). The ALPPS technique (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy) effectively increased the resectability of otherwise inoperable liver tumors (primary or secondary malignant liver tumor) by achieving a rapid and an effective hypertrophy of the FLR, which lowers postoperative liver failure risk...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28675363/comparative-analysis-between-simultaneous-resection-and-staged-resection-for-synchronous-colorectal-liver-metastases-a-single-center-experience-on-300-consecutive-patients
#18
Sorin Alexandrescu, Andrei Diaconescu, Zenaida Ionel, Cristian Zlate, Răzvan Grigorie, Doina Hrehoreţ, Vladislav Braşoveanu, Simona Dima, Florin Botea, Mihnea Ionescu, Dana Tomescu, Gabriela Droc, Ruxandra Fota, Adina Croitoru, Iulia Gramaticu, Florina Buica, Razvan Iacob, Cristian Gheorghe, Vlad Herlea, Mugur Grasu, Radu Dumitru, Mirela Boroş, Irinel Popescu
Introduction: In synchronous colorectal liver metastases (SCLMs), simultaneous resection (SR) of the primary tumor and liver metastases has not gained wide acceptance. Most authors prefer staged resections (SgR), especially in patients presenting rectal cancer or requiring major hepatectomy. Methods: Morbidity, mortality, survival rates and length of hospital stay were compared between the two groups of patients (SR vs. SgR). A subgroup analysis was performed for patients with similar characteristics (e.g. rectal tumor, major hepatectomy, bilobar metastases, metastatic lymph nodes, preoperative chemotherapy)...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28668897/hepatectomy-for-liver-metastases-of-colorectal-cancer-after-adoptive-chemoimmunotherapy-using-activated-%C3%AE-%C3%AE-t-cells
#19
Fuminori Ishii, Yoichiro Yoshida, Yasushi Yamauchi, Naoya Aisu, Daibo Kojima, Toshiyuki Mera, Daisuke Kato, Toshihiro Tanaka, Keiko Naito, Kosei Yasumoto, Takashi Kamigaki, Shigenori Goto, Yoshihiro Hamada, Satoshi Nimura, Shohta Kodama, Suguru Hasegawa
BACKGROUND/AIM: Various types of chemoimmunotherapies for malignant tumors have been reported. However, there are few reports on hepatectomy after chemoimmunotherapy. We evaluated the safety and efficacy of hepatectomy for patients with stage IV colorectal liver metastases (CLM) after chemoimmunotherapy using activated αβ T-cells. PATIENTS AND METHODS: From June 2012 to December 2016, five patients who underwent hepatectomy after receiving capecitabine and oxaliplatin (XELOX) plus bevacizumab and ex vivo-expanded αβ T-lymphocytes as first-line chemoimmunotherapy were included...
July 2017: Anticancer Research
https://www.readbyqxmd.com/read/28655075/-surgical-treatment-of-colorectal-liver-metastases
#20
J M Xu, D X Zhu, L Ren
Surgical resection of the metastases offers the only opportunity for long-term survival in colorectal liver metastases. However, only 10% to 20% of patients present with resectable disease, and so how to increase surgical patients has been a clinical hotspot. In addition to expanding surgical indications, two-stage hepatectomy and convertible therapy are optional. In convertible therapy, initial treatment regimen decides long-term benefit, and it is important to select appropriate patient population in addition to Ras status when anti-epithelial growth factor receptor monoclonal antibody is used...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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