Optimal timing for removal of abdominal drainage after liver resection for hepatocellular carcinoma.

The aim of this study was to retrospectively assess the optimal timing for removal of abdominal drainage after liver resection for hepatocellular carcinoma (HCC). A total of 148 patients were divided into 2 groups. In Group I, drains were removed according to the judgment of the surgeon. In Group II, drains were removed on postoperative day (POD) 2, except in cases of bile leakage, purulent ascites, or hemorrhage. Postoperative complications were compared between the 2 groups. Postoperative hospital stay was shorter in Group II than in Group I. Six patients required drain reinsertion for abdominal abscess and massive ascites. The risk factor for drain reinsertion was volume of drain discharge greater than 450 mL on POD 2. Early removal of the drain is desirable after surgical treatment of HCC. Moreover, it seems preferable to determine the necessity of drain removal based on assessment of the volume and nature of drain discharge on POD 2.

[A case of liver metastasis of breast cancer successfully treated with paclitaxel infusion into the hepatic artery: an attempt of once weekly regimen].

On October 21, 1995, a 45-year-old woman underwent mastectomy (Kodama's procedure), preserving the thoracic muscles, based on the diagnosis of right breast cancer (T2aN1bM0). After surgery, she received 3 cycles of adjuvant chemotherapy (CAF) using anthracycline and other drugs. Thereafter she was orally treated with UFT for 2 years. She developed tumor recurrence in her liver 3 years after surgery. At that time, she was initially scheduled to undergo partial hepatectomy (including the tumor-affected area), but it was later judged that radical surgery was impossible due to the presence of multiple lesions in both lobes of the liver. A reservoir was therefore installed in the hepatic artery. Ten days after reservoir installation, intra-arterial infusion of paclitaxel (80 mg/m2), dissolved in 100 ml of physiological saline, was performed for one hour, using the installed reservoir. This treatment was administered once weekly for 3 consecutive weeks, followed by one week of rest. After 3 cycles of this regimen, the liver metastases had disappeared completely. At present, 2 years after the beginning of this therapy, the patient remains in a state of CR (complete response). Grade 2 alopecia and grade 1 peripheral neuropathy were the only adverse reactions observed.