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98 papers 25 to 100 followers
Christopher W Mangieri, Jason C McCartt, Matthew A Strode, John E Lowry, Prasad M Balakrishna
BACKGROUND: As hepatic surgery has become safer and more commonly performed, the extent of hepatic resections has increased. When there is not enough expected hepatic reserve to facilitate primary resection of hepatic tumors, a clinical adjunct to facilitating primary resection is portal vein embolization (PVE). PVE allows the hepatic remnant to increase to an appropriate size prior to resection via hepatocyte regeneration; however, PVE is not always successful in facilitating adequate regeneration...
October 17, 2016: Surgical Endoscopy
Raphael L C Araujo, Rachel P Riechelmann, Yuman Fong
Advances in surgery and chemotherapy regimens have increased the long-term survival of patients with colorectal liver metastases (CRLM). Although liver resection remains an essential part of any curative strategy for resectable CRLM, chemotherapy regimens have also improved the long-term outcomes. However, the optimal timing for chemotherapy regimens remains unclear. Thus, this review addressed key points to aid the decision-making process regarding the timing of chemotherapy and surgery for patients with resectable CRLM...
October 25, 2016: Journal of Surgical Oncology
D Eshmuminov, D A Raptis, M Linecker, A Wirsching, M Lesurtel, P-A Clavien
BACKGROUND: Discussion is ongoing regarding whether associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) or portal vein occlusion is better in staged hepatectomy. The aim of this study was to compare available strategies using a two-stage approach in extended hepatectomy. METHODS: A literature search was performed in MEDLINE, Scopus, the Cochrane Library and Embase, and additional articles were identified by hand searching. Data from the international ALPPS registry were extracted...
December 2016: British Journal of Surgery
Albert C Y Chan, Kenneth Chok, Jeff W C Dai, Chung Mau Lo
BACKGROUND: Recent evidence suggested that associating liver partition and portal vein ligation for staged hepatectomy with a partial split could effectively induce the same degree of future liver remnant hypertrophy as a complete split in non-cirrhotic and non-cholestatic livers with better postoperative safety profiles. Our aim was to evaluate if the same phenomenon could be applied to hepatitis-related chronic liver diseases. METHODS: In the study, 25 patients who underwent associating liver partition and portal vein ligation for staged hepatectomy from October 2013 to January 2016 for hepatocellular carcinoma were analyzed...
February 2017: Surgery
S Mokhles, F Macbeth, V Farewell, F Fiorentino, N R Williams, R N Younes, J J M Takkenberg, T Treasure
BACKGROUND: After potentially curative resection of primary colorectal cancer, patients may be monitored by measurement of carcinoembryonic antigen and/or CT to detect asymptomatic metastatic disease earlier. METHODS: A systematic review and meta-analysis was conducted to find evidence for the clinical effectiveness of monitoring in advancing the diagnosis of recurrence and its effect on survival. MEDLINE (Ovid), Embase, the Cochrane Library, Web of Science and other databases were searched for randomized comparisons of increased intensity monitoring compared with a contemporary standard policy after resection of primary colorectal cancer...
September 2016: British Journal of Surgery
Y J Chang, K P Chung, Y J Chang, L J Chen
BACKGROUND: This study aimed to assess long-term survival after liver resection for huge hepatocellular carcinoma (HCC). METHODS: Patients with stage I-III HCC who underwent hepatectomy from 2002 to 2010 were identified retrospectively from prospective national databases and followed until December 2012. Patients were assigned into four groups according to tumour size: less than 3·0 cm (small), 3·0-4·9 cm (medium), 5·0-10·0 cm (large) and over 10·0 cm (huge)...
October 2016: British Journal of Surgery
F K S Welsh, K Chandrakumaran, T G John, A B Cresswell, M Rees
BACKGROUND: Liver resection before primary cancer resection is a novel strategy advocated for selected patients with synchronous colorectal liver metastases (sCRLM). This study measured outcomes in patients with sCRLM following a liver-first or classical approach, and used a validated propensity score. METHODS: Clinical, pathological and follow-up data were collected prospectively from consecutive patients undergoing hepatic resection for sCRLM at a single centre (2004-2014)...
April 2016: British Journal of Surgery
Guangfu Li, Dai Liu, Timothy K Cooper, Eric T Kimchi, Xiaoqiang Qi, Diego M Avella, Ningfei Li, Qing X Yang, Mark Kester, C Bart Rountree, Jussuf T Kaifi, David J Cole, Don C Rockey, Todd D Schell, Kevin F Staveley-O'Carroll
BACKGROUND & AIMS: We have established a clinically relevant animal model of hepatocellular cancer (HCC) in immune competent mice to elucidate the complex dialog between host immunity and tumors during HCC initiation and progression. Mechanistic findings have been leveraged to develop a clinically feasible anti-tumor chemoimmunotherapeutic strategy. METHODS: Intraperitoneal injection of carbon tetrachloride and intrasplenic inoculation of oncogenic hepatocytes were combined to induce progressive HCCs in fibrotic livers of immunocompetent mice...
January 2017: Journal of Hepatology
Michael Linecker, Gregor A Stavrou, Karl J Oldhafer, Robert M Jenner, Burkhardt Seifert, Georg Lurje, Jan Bednarsch, Ulf Neumann, Ivan Capobianco, Silvio Nadalin, Ricardo Robles-Campos, Eduardo de Santibañes, Massimo Malagó, Mickael Lesurtel, Pierre-Alain Clavien, Henrik Petrowsky
OBJECTIVES: To create a prediction model identifying futile outcome in ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) before stage 1 and stage 2 surgery. BACKGROUND: ALPPS is a 2-stage hepatectomy, which incorporates parenchymal transection at stage 1 enabling resection of extensive liver tumors. One of the major criticisms of ALPPS is the associated high mortality rate up to 20%. METHODS: Using the International ALPPS Registry, a risk analysis for futile outcome (defined as 90-day or in-hospital mortality) was performed...
November 2016: Annals of Surgery
Mitsugi Shimoda, Kazuma Tago, Takayuki Shiraki, Shozo Mori, Masato Kato, Taku Aoki, Keiichi Kubota
BACKGROUND AND OBJECTIVES: Hepatic resection is established as the treatment for HCC. However, patients sometimes experience early recurrence of HCC (ER HCC) after curative resection. METHODS: A retrospective analysis was conducted for 193 patients with single HCC who underwent curative liver resection in our medical center between April 2000 and March 2013. We divided the cohort into two groups; early recurrence group (ER G) which experienced recurrence within 6 months after resection, and non-early recurrence group (NER G)...
October 2016: World Journal of Surgery
John R Bergquist, Tommy Ivanics, Curtis B Storlie, Ryan T Groeschl, May C Tee, Elizabeth B Habermann, Rory L Smoot, Michael L Kendrick, Michael B Farnell, Lewis R Roberts, Gregory J Gores, David M Nagorney, Mark J Truty
BACKGROUND: Optimal management of patients with intrahepatic cholangiocarcinoma (ICCA) and elevated CA19-9 remains undefined. We hypothesized CA19-9 elevation above normal indicates aggressive biology and that inclusion of CA19-9 would improve staging discrimination. METHODS: The National Cancer Data Base (NCDB-2010-2012) was reviewed for patients with ICCA and reported CA19-9. Patients were stratified by CA19-9 above/below normal reference range. Unadjusted Kaplan-Meier and adjusted Cox-proportional-hazards analysis of overall survival (OS) were performed...
September 2016: Journal of Surgical Oncology
Boris Galjart, Eric P van der Stok, Joost Rothbarth, Dirk J Grünhagen, Cornelis Verhoef
INTRODUCTION: Posttreatment surveillance protocols most often endure for 5 years after resection of colorectal liver metastasis (CRLM). Most recurrences happen within 3 years after surgical removal of the tumour. This study analysed the need of surveillance for patients with at least 3 years of disease-free survival after potentially curative resection of CRLM. METHODS: A single-centre, retrospective analysis of all consecutive patients who underwent treatment for CRLM with curative intent between 2000 and 2011...
July 8, 2016: Annals of Surgical Oncology
Yu-Long Cai, Pei-Pei Song, Wei Tang, Nan-Sheng Cheng
The main obstacle to achieving an R0 resection after a major hepatectomy is inability to preserve an adequate future liver remnant (FLR) to avoid postoperative liver failure (PLF). Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel technique for resecting tumors that were previously considered unresectable, and this technique results in a vast increase in the volume of the FLR in a short period of time. However, this technique continues to provoke heated debate because of its high mortality and morbidity...
June 2016: Medicine (Baltimore)
Jan Grendar, Jean F Ouellet, Andrew McKay, Francis R Sutherland, Oliver F Bathe, Chad G Ball, Elijah Dixon
BACKGROUND AND OBJECTIVES: Liver failure following hepatic resection is a multifactorial complication. In experimental studies, infusion of N-acetylcysteine (NAC) can minimize hepatic parenchymal injury. METHODS: Patients undergoing liver resection were randomized to postoperative care with or without NAC. No blinding was performed. Overall complication rate was the primary outcome; liver failure, length of stay, and mortality were secondary outcomes. Due to safety concerns, a premature multivariate analysis was performed and included within the model randomization to NAC, preoperative ASA, extent of resection, and intraoperative vascular occlusion as factors...
September 2016: Journal of Surgical Oncology
Vankadari Kousik, Pankaj Promila, Ritu Verma, Arun Gupta
BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) is the sixth most common cancer and third leading cause of cancer-related death in the world. The management of unresectable HCC and hepatic metastases from various solid tumors is a clinical dilemma. There is paucity of data on the treatment of unresectable HCC and hepatic metastases with yttrium-90 (90Y) radioembolization. METHODS: Thirty patients (mean age; 55.2 years; range 43-82 years) comprising 21 patients with HCC (12 patients have cirrhosis of which 3 patients belong to Child-Pugh class A and 9 patients belong to Child-Pugh class B), 7 patients with metastasis from colorectal cancer, 1 patient with metastasis from melanoma, and 1 patient with metastasis from ovarian carcinoma underwent resin-based 90Y radioembolization between 2013 and 2015 in our study...
May 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
G A Margonis, N Amini, S Buettner, S Besharati, Y Kim, F Sobhani, I R Kamel, T M Pawlik
BACKGROUND: Although perioperative platelet count has been associated with postoperative morbidity and mortality, its impact on liver regeneration has not been examined directly. This study sought to determine the impact of platelet count on liver regeneration after major liver resection using cross-sectional imaging volumetric assessment. METHODS: Patients who underwent major liver resection between 2004 and 2015 and had available data on immediate postoperative platelet count, as well as preoperative and postoperative CT images, were identified retrospectively...
June 2016: British Journal of Surgery
Guillaume Passot, Yun Shin Chun, Scott E Kopetz, Daria Zorzi, Kristoffer Watten Brudvik, Bradford J Kim, Claudius Conrad, Thomas A Aloia, Jean-Nicolas Vauthey
BACKGROUND: In patients with bilateral colorectal liver metastases (CLM) not resectable in 1 operation, 2-stage hepatectomy is the standard surgical approach. The objective of this study was to determine factors associated with safety and efficacy of 2-stage hepatectomy. STUDY DESIGN: The study included all 109 patients for whom 2-stage hepatectomy for CLM was planned during 2003 to 2014. The RAS mutation status and other clinicopathologic factors were evaluated for association with major complications and survival using multivariate analysis...
July 2016: Journal of the American College of Surgeons
A J Page, F Gani, K T Crowley, K H K Lee, M C Grant, T L Zavadsky, D Hobson, C Wu, E C Wick, T M Pawlik
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways have been associated with improved perioperative outcomes following several surgical procedures. Less is known, however, regarding their use following hepatic surgery. METHODS: An evidence-based, standardized perioperative care pathway was developed and implemented prospectively among patients undergoing open liver surgery between 1 January 2014 and 31 July 2015. Perioperative outcomes, including length of hospital stay, postoperative complications and healthcare costs, were compared between groups of patients who had surgery before and after introduction of the ERAS pathway...
April 2016: British Journal of Surgery
A Dupré, M Hitier, P Peyrat, Y Chen, P Meeus, M Rivoire
BACKGROUND: Insufficient volume of the future liver remnant (FLR) is a major cause of unresectability in patients with bilobar colorectal liver metastases (CLM). The objective of this study was to evaluate the safety and efficacy of the novel associating portal embolization and artery ligation (APEAL) technique before extended right hepatectomy during a two-stage procedure for CLM. METHODS: All patients who had undergone extended right hepatectomy during two-stage surgery for CLM between 2012 and 2014 were identified retrospectively from a prospectively maintained database...
November 2015: British Journal of Surgery
Jiang Long, Jia-sheng Zheng, Bin Sun, Ningning Lu
AIMS: To prospectively assess the use of microwave ablation (MWA) to treat hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) after transarterial chemoembolization (TACE), and to evaluate factors that significantly affect treatment outcomes. METHODS: Sixty patients with HCC [55 male, 5 female; mean age, 54.1 ± 10.2 (range 36-77) years] + PVTT were enrolled. Patients were treated with MWA after TACE. Results were compared with those of 54 patients treated by TACE alone in another retrospective study...
January 2016: Hepatology International
2016-01-28 05:58:33
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