The Liver Tunnel: Intention-to-treat Validation of a New Type of Hepatectomy.
Ann Surg
; 269(2): 331-336, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-28902667
ABSTRACT
OBJECTIVE:
This prospective intention-to-treat validation study evaluated the liver tunnel (LT) technique for patients having ≥1 deep centrally located liver tumor, with or without middle hepatic vein (MHV) invasion.BACKGROUND:
Conservative surgery has been proposed for patients with deep liver tumors having complex relationships. LT is one such novel technique.METHODS:
Eligible patients were prospectively enrolled for LT. LT relies on tumor-vessel detachment, and the presence of communicating veins if MHV resection is necessary.RESULTS:
Twenty consecutive patients met the inclusion criteria 17 had colorectal liver metastases, 1 had hepatocellular carcinoma, 1 had mass-forming cholangiocarcinoma, and 1 had mixed hepatocellular carcinoma-mass-forming cholangiocarcinoma. Nineteen patients underwent LT. The MHV was resected in 6 patients, always sparing segments 4i and 5. Overall, 180 lesions were removed (median 7; range 1-37) 79 lesions were included in the LT specimen (median 3; range 1-13). There was no in-hospital 90-day mortality. Overall morbidity occurred in 10 (50%) patients major in 2 (10%). All complications were managed conservatively. After a median 15-month follow-up (range 6-48), 2 instances of cut-edge local recurrences were observed.CONCLUSIONS:
This study shows that LT is technically feasible and safe. Further studies are needed for standardizing its use.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hepatectomia
/
Neoplasias Hepáticas
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Ann Surg
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália