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Two stage hepatectomy

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https://www.readbyqxmd.com/read/29454099/two-stage-hepatectomy-vs-one-stage-major-hepatectomy-with-contralateral-resection-or-ablation-for-advanced-bilobar-colorectal-liver-metastases
#1
Takashi Mizuno, Jordan M Cloyd, Kiyohiko Omichi, Yun Shin Chun, Claudius Conrad, Ching-Wei D Tzeng, Steven H Wei, Thomas A Aloia, Jean-Nicolas Vauthey
BACKGROUND: Both two-stage hepatectomy (TSH) and one-stage hepatectomy (OSH) represent feasible strategies for resection of advanced bilobar colorectal liver metastases (CLM). However, the influence of the surgical approach on postoperative outcomes and overall survival (OS) is unknown. To define the optimal surgical approach for advanced bilobar CLM requiring right hemihepatectomy, we compared short-term and long-term outcomes following TSH and OSH with contralateral resection or radiofrequency ablation (RFA)...
February 14, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29453737/two-stage-hepatectomy-aiming-for-the-development-of-intrahepatic-venous-collaterals-for-multiple-colorectal-liver-metastases
#2
Harufumi Maki, Shouichi Satou, Kentaro Nakajima, Atsuki Nagao, Kazuteru Watanabe, Hitoshi Satodate, Satoshi Nara, Kaoru Furushima, Yasushi Harihara
BACKGROUND: Aggressive hepatectomy with venous resection has a higher risk of postoperative liver failure (POLF) than hepatectomy without venous reconstruction; however, venous reconstruction is technically demanding. We performed a novel two-stage hepatectomy (TSH) without venous reconstruction in a patient with bilobar multiple colorectal liver metastases located near the caval confluence, waiting for the development of intrahepatic venous collaterals between procedures. CASE PRESENTATION: A 60-year-old man was referred to our hospital with sigmoid colon cancer accompanied by intraabdominal abscess and two synchronous liver metastases...
February 16, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29444146/prediction-of-small-for-size-syndrome-after-extended-hepatectomy-tissue-characterization-by-relaxometry-diffusion-weighted-magnetic-resonance-imaging-and-magnetization-transfer
#3
Christian Eberhardt, Moritz C Wurnig, Andrea Wirsching, Cristina Rossi, Idana Feldmane, Mickael Lesurtel, Andreas Boss
This study aimed to monitor the course of liver regeneration by multiparametric magnetic-resonance imaging (MRI) after partial liver resection characterizing Small-for-Size Syndrome (SFSS), which frequently leads to fatal post-hepatectomy liver failure (PLF). Twenty-two C57BL/6 mice underwent either conventional 70% partial hepatectomy (cPH), extended 86% partial hepatectomy (ePH) or SHAM operation. Subsequent MRI scans on days 0, 1, 2, 3, 5 and 7 in a 4.7T MR Scanner quantified longitudinal and transverse relaxation times, apparent diffusion coefficient (ADC) and the magnetization-transfer ratio (MTR) of the regenerating liver parenchyma...
2018: PloS One
https://www.readbyqxmd.com/read/29439275/is-enhanced-one-stage-hepatectomy-a-safe-and-feasible-alternative-to-the-two-stage-hepatectomy-in-the-setting-of-multiple-bilobar-colorectal-liver-metastases-a-comparative-analysis-between-two-pioneering-centers
#4
Guido Torzilli, Luca Viganò, Matteo Cimino, Katsunori Imai, Eric Vibert, Matteo Donadon, Doaa Mansour, Denis Castaing, Ren Adam
BACKGROUND: Two-stage hepatectomy (TSH) is the present standard for multiple bilobar colorectal metastases (CLM). As alternative, ultrasound-guided one-stage hepatectomy (E-OSH) has been proposed even for deep-located nodules to compare TSH and E-OSH. METHODS: All consecutive TSH at the Paul Brousse Hospital and E-OSH at the Humanitas Research Hospital were considered. The inclusion criteria were ≥6 CLM, ≥3 CLM in the left liver, and ≥1 lesion with vascular contact...
February 13, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29425829/assessment-and-optimization-of-liver-volume-before-major-hepatic-resection-current-guidelines-and-a-narrative-review
#5
REVIEW
Adeel S Khan, Sandra Garcia-Aroz, Mohammad A Ansari, Syed M Atiq, Michael Senter-Zapata, Kathryn Fowler, M B Doyle, W C Chapman
Post hepatectomy liver failure (PHLF) remains a significant cause of morbidity and mortality after major liver resection. Although the etiology of PHLF is multifactorial, an inadequate functional liver remnant (FLR) is felt to be the most important modifiable predictor of PHLF. Pre-operative evaluation of FLR function and volume is of paramount importance before proceeding with any major liver resection. Patients with inadequate or borderline FLR volume must be considered for volume optimization strategies such as portal vein embolization (PVE), two stage hepatectomy with portal vein ligation (PVL), Yttrium-90 radioembolization, and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)...
February 6, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29394831/-a-case-of-a-two-stage-hepatectomy-for-irresectable-colorectal-cancer-liver-metastases
#6
Yoshiro Yukawa, Kohei Murata, Yoshinori Kagawa, Takuya Sakamoto, Junichi Inatome, Atsushi Naito, Kohei Murakami, Yoshiteru Katsura, Yoshiaki Ohmura, Atsushi Takeno, Chiyomi Egawa, Shinichi Nakatsuka, Takeshi Kato, Shigeyuki Tamura, Yutaka Takeda
A 60-year-oldman was diagnosedwith ascending colon cancer with multiple bilobar metastases. He then received7 courses of tegafur-gimeracil-oteracil andoxaliplatin (SOX)plus panitumumab as downstaging chemotherapy. This treatment significantly reducedthe size of the metastatic tumor, andwe subsequently triedto perform a curative resection. A twostage hepatectomy was plannedto avoidthe risk of hepatic failure from small future liver remnant. First, the anterior segmentectomy andthe left portal vein ligation were performed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29362330/-two-cases-of-colon-metastasis-of-gastric-cancer-by-different-metastasis-pathway
#7
Ichiro Higuchi, Yosuke Akiyama, Akira Ishikawa, Sanae Hosomi, Takahiko Tanigawa, Yasunori Hasuike, Makoto Miyamoto
We treated 2 cases ofcolon metastasis ofgastric cancer considered to be caused by different pathway. Case 1 was a 55- year-old male with gastric cancer associated with metastases for lymph node, gallbladder, and liver. Curative surgical treatment of distal gastrectomy, partial hepatectomy, cholecystectomy and lymph node dissection was performed. The final find- ing was, L, Less, Type 3, pT4b(GB), tub2, pN3a(10/20), sP0, CY0, pH1, pM1, Stage IV , R0. Ten months after, ileocecal resection was performed, as a tumor was detected in the cecum...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29359240/feasibility-of-percutaneous-intrahepatic-split-by-microwave-ablation-pisa-after-portal-vein-embolization-for-hypertrophy-of-future-liver-remnant-the-radiological-stage-1-alpps
#8
Alessandro Lunardi, Rosa Cervelli, Duccio Volterrani, Saverio Vitali, Carlo Lombardo, Giulia Lorenzoni, Laura Crocetti, Irene Bargellini, Daniela Campani, Luca Emanuele Pollina, Roberto Cioni, Davide Caramella, Ugo Boggi
PURPOSE: To assess the feasibility of radiological stage-1 ALPPS, associating liver partition and portal vein ligation for staged hepatectomy, by combining portal vein embolization (PVE) with percutaneous intrahepatic split by ablation (PISA). MATERIALS AND METHODS: Three patients (mean age 65.0 ± 7.3 years) underwent PVE and PISA. PISA was performed 21 days after PVE by microwave ablation to create a continuous intrahepatic cutting plane. Abdominal CT examinations were performed before and after PVE and PISA...
January 22, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29325786/a-proactive-outreach-intervention-that-decreases-readmission-after-hepatectomy
#9
Nisha Narula, Bradford J Kim, Catherine H Davis, Whitney L Dewhurst, Leigh A Samp, Thomas A Aloia
BACKGROUND: After hepatectomy, 7%-19% of patients are readmitted within 30 days, accounting for substantial cost and poor patient experience. The purpose of this study was to analyze the impact of a proactive outreach intervention on readmissions. METHODS: Consecutive patients undergoing hepatectomy by a single surgeon 2012-2016 were identified in a prospectively maintained database. In August 2013 a postoperative intervention was implemented; an advanced practice provider called each patient within 72 hours of discharge...
January 9, 2018: Surgery
https://www.readbyqxmd.com/read/29318366/-surgical-innovations-in-treatment-of-metastatic-colorectal-cancer-complexity-of-metastatic-surgery-as-example-for-personalized-medicine
#10
REVIEW
C Hackl, S M Brunner, K M Schmidt, H J Schlitt
BACKGROUND: Extensive, bilobular and multifocal colorectal liver metastases (CLM) or metastases that are critically situated require an experienced surgeon and advanced surgical techniques to enable curative resection. OBJECTIVE: This article describes the toolbox of hepato-oncologic surgery including functional augmentation of liver segments by portal vein embolization/ligation, combinations of ablation and resection, two-stage resections and in situ split liver resection, also known as associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)...
January 9, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29258518/associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-versus-conventional-two-stage-hepatectomy-a-systematic-review-and-meta-analysis
#11
Zheng Zhou, Mingxing Xu, Nan Lin, Chuzhi Pan, Boxuan Zhou, Yuesi Zhong, Ruiyun Xu
BACKGROUND: It is generally accepted that an insufficient future liver remnant is a major limitation of large-scale hepatectomy for patients with primary hepatocellular carcinoma. Conventional two-stage hepatectomy (TSH) is commonly considered to accelerate future liver regeneration despite its low regeneration rate. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), which is characterized by a rapid regeneration, has brought new opportunities. METHODS: Relevant studies were identified by searching the selected databases up to September 2017...
December 19, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29248180/impact-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-on-growth-of-colorectal-liver-metastases
#12
Patryk Kambakamba, Michael Linecker, Marcel Schneider, Cäcilia S Reiner, Thi Dan Linh Nguyen-Kim, Perparim Limani, Ivan Romic, Joan Figueras, Henrik Petrowsky, Pierre-Alain Clavien, Mickaël Lesurtel
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy induces an unprecedented liver hypertrophy and enables resection of otherwise unresectable liver tumors. The effect of associating liver partition and portal vein ligation for staged hepatectomy on tumor proliferation, however, remains a concern. This study investigated the impact of associating liver partition and portal vein ligation for staged hepatectomy on growth of colorectal metastases in mice and in humans...
December 13, 2017: Surgery
https://www.readbyqxmd.com/read/29239077/high-incidence-of-biliary-stricture-after-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy
#13
Srinivas Sanjeevi, Ernesto Sparrelid, Stefan Gilg, Eduard Jonas, Bengt Isaksson
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a two-stage procedure most frequently applied in the setting of an extended right-sided hemi-hepatectomy. Initial reports of high mortality have sparked debate regarding the safety and efficacy of the procedure. We describe a higher incidence of early post-operative bile duct strictures after ALPPS, a complication rarely seen after conventional liver resection. METHODS: An institutional review was conducted to assess the incidence of post-operative biliary strictures following conventional right-sided or extended right-sided hemi-hepatectomy and ALPPS...
December 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29224266/-application-of-liver-three-dimensional-visualization-technologies-in-the-treatment-planning-of-hepatic-malignant-tumor
#14
P P Li, Z H Wang, G Huang, Z P Huang, Y Li, J S Ni, H Liu, C H Fang, W P Zhou
Objective: To discuss the application of three dimentional(3D)visualization technologies in treatment plan of hepatic malignant tumor. Methods: The clinical data of 300 patients with liver malignant tumor who received treatment from January 2016 to January 2017 in the Third Department of Hepatic Surgery of Eastern Hepatobiliary Surgery Hospital was retrospectively analyzed in this study, including 221 male and 79 female patients aged from 7 to 76 years with median age of 54 years. The median height was 168 cm (115-183 cm), the median weight was 65 kg (20-105 kg) and the median tumor volume was 142 ml (23-2 493 ml)...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29168098/proposal-of-a-new-preoperative-prognostic-model-for-solitary-hepatocellular-carcinoma-incorporating-18-f-fdg-pet-imaging-with-the-albi-grade
#15
Tomoaki Yoh, Satoru Seo, Satoshi Ogiso, Takayuki Kawai, Yukihiro Okuda, Takamichi Ishii, Kojiro Taura, Tatsuya Higashi, Yuji Nakamoto, Etsuro Hatano, Toshimi Kaido, Shinji Uemoto
BACKGROUND: Existing prognostic systems were not developed using only objective variables available preoperatively, and therefore do not provide ideal prognostication for patients undergoing hepatectomy for hepatocellular carcinoma (HCC). We aimed to develop a preoperative prognostic model using objective variables involving two parameters: (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG-PET) and the albumin-bilirubin (ALBI) grade. METHODS: This study included 207 consecutive patients with solitary HCC who underwent (18)F-FDG-PET prior to hepatectomy...
November 22, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29165812/a-novel-and-validated-prognostic-nomogram-based-on-liver-fibrosis-and-tumor-burden-for-patients-with-hepatocellular-carcinoma-after-curative-resection
#16
Jin-Long Huang, Yi-Peng Fu, Chu-Yu Jing, Yong Yi, Jian Sun, Wei Gan, Zhu-Feng Lu, Jian Zhou, Jia Fan, Shuang-Jian Qiu
BACKGROUND AND OBJECTIVES: Most conventional staging systems were formulated concerning the tumor burden rather than the severity of liver fibrosis, which plays a central role in tumor promotion. The aim of this study was to formulate a prognostic nomogram comprehensively considering these two aspects for HCC after hepatectomy. METHODS: The prognostic significances of the four indicators namely laminin, hyaluronic acid, human procollagen type-III, and collagen type-IV that reflect liver fibrosis were explored in two independent cohorts...
November 22, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29139083/comparison-of-hepatectomy-for-patients-with-metabolic-syndrome-related-hcc-and-hbv-related-hcc
#17
Yunhong Tian, Huan Lyu, Yunhong He, Yong Xia, Jun Li, Feng Shen
BACKGROUND: Metabolic syndrome (MetS) is a group of clinicopathological manifestations. The outcome of liver surgery in metabolic syndrome-related hepatocellular carcinoma (MetS-HCC) still needs to be evaluated. We aim to clarify the outcomes following liver resection in patients with MetS-HCC compared those with hepatitis B virus-related HCC (HBV-HCC). METHODS: All the consecutive patients undergoing hepatectomy for HCC between January 2009 and December 2012 were retrospectively considered...
November 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29098384/prognostic-influence-of-hepatic-margin-after-resection-of-colorectal-liver-metastasis-role-of-modern-preoperative-chemotherapy
#18
Frank Makowiec, Peter Bronsert, Andrea Klock, Ulrich T Hopt, Hannes P Neeff
PURPOSE: Modern chemotherapy (CTX) increases survival in stage IV colorectal cancer. In colorectal liver metastases (CLM), neoadjuvant (neo) CTX may increase resectability and improve survival. Due to widespread use of CTX in CLM, recent studies assessed the role of the hepatic margin after CTX, with conflicting results. We evaluated the outcome after resection of CLM in relation to CTX and hepatic resection status. METHODS: Since 2000, 334 patients with first hepatic resection for isolated CLM were analyzed...
January 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29069032/laparoscopic-associating-liver-tourniquet-and-portal-ligation-combined-rescue-transhepatic-arterial-embolization-for-staged-hepatectomy-a-case-report
#19
Jian Xu, Xiangyu Lu, Yu Zhang, Hongji Yang, Xiaojiong Yu
RATIONALE: Staged hepatectomy is an important surgical method for large hepatocellular carcinoma (HCC). However, the insufficient future liver remnant (FLR) is still the major barrier in stage II hepatectomy. We herein reported a case of laparoscopic associating liver tourniquet and portal ligation combined rescue transhepatic arterial embolization (TAE) for staged hepatectomy. PATIENT CONCERNS: Laparoscopic associating liver tourniquet and portal ligation for staged hepatectomy (ALTPS) was performed for cirrhotic HCC in stage I...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29052842/shear-stress-upregulates-regeneration-related-immediate-early-genes-in-liver-progenitors-in-3d-ecm-like-microenvironments
#20
Kenichiro Nishii, Erik Brodin, Taylor Renshaw, Rachael Weesner, Emma Moran, Shay Soker, Jessica L Sparks
The role of fluid stresses in activating the hepatic stem/progenitor cell regenerative response is not well understood. This study hypothesized that immediate early genes (IEGs) with known links to liver regeneration will be upregulated in liver progenitor cells (LPCs) exposed to in vitro shear stresses on the order of those produced from elevated interstitial flow after partial hepatectomy. The objectives were: (1) to develop a shear flow chamber for application of fluid stress to LPCs in 3D culture; and (2) to determine the effects of fluid stress on IEG expression in LPCs...
October 20, 2017: Journal of Cellular Physiology
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