RESUMEN
INTRODUCTION: A technique of reconstructing the inguinal ligament using pedicled fascia lata flap is described. PRESENTATION OF CASE: A 66-year-old woman was referred with massive incarcerated left inguinal hernia, following acute surgery on a femoral vein leasion and numerous attempts at repair and subsequent recurrences. There was complete absence of the left inguinal ligament. The inguinal ligament was reconstructed using a strip of fascia lata, pedicled on the anterior superior iliac spine. This was transposed to cover the external iliac vessels, and sutured to the pubic tubercle. The musculoaponeurotic abdominal wall was reconstructed with 15×13 cm sheet of polypropylene mesh, placed preperitoneal and sutured to the remaining abdominal wall muscles and to the neo-Pouoart ligament. DISCUSSION: Complete destruction of the inguinal ligament is rare but can occur following multiple operative procedures or trauma. Published reports of inguinal ligament reconstruction have been performed using synthetic mesh. The use of autologous tissue should reduce the risk of erosion into the neurovascular bundle, seroma formation, and enhance integration into surrounding tissues. CONCLUSION: This new technique for autologous reconstruction of the inguinal ligament provides a safe alternative to the use of synthetic mesh in the operative armamentarium of plastic and general surgeons. This is the first reported case in Hungary.
Asunto(s)
Vena Femoral/cirugía , Hernia Inguinal/cirugía , Ligamentos Articulares/cirugía , Colgajos Quirúrgicos , Pared Abdominal , Anciano , Fascia Lata , Humanos , Complicaciones Posoperatorias/etiología , Procedimientos de Cirugía Plástica/métodos , Reoperación , Resultado del TratamientoRESUMEN
The results obtaining with breast reconstruction surgery are not always satisfactory for the patients. Reconstruction with pure latissimus dorsi flap is useful option and due to endoscopic harvest large scar on the back can be avoided. The skin sparing mastectomy and even the sentinel lymph node biopsy or lymphadenectomy can be performed using a single incision in the axilla. Also the immediate reconstruction with endoscopically assisted harvest of the latissimus dorsi muscle flap in selective cases can be done using the same incision. The patient reported high satisfaction with the aesthetic and functional results due to preservation the breast shape and the absence of any scarring on the back.
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Axila/cirugía , Neoplasias de la Mama/cirugía , Mamoplastia/métodos , Mastectomía , Músculos Superficiales de la Espalda/trasplante , Colgajos Quirúrgicos , Neoplasias de la Mama/patología , Endoscopía/métodos , Femenino , Humanos , Escisión del Ganglio Linfático , Mastectomía/métodos , Procedimientos de Cirugía Plástica/métodos , Biopsia del Ganglio Linfático Centinela , Recolección de Tejidos y Órganos/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: The only definitive treatment of chronic axillar hidradenitis suppurativa (HS) that prevents relapses is 'in toto' excision of the infected glandular tissue. This way a deficiency emerges, which needs to be restored. Reconstruction with split skin graft (SSG) is a most common way of recovery, but thoracodorsal artery perforator (TDAP) fasciocutneous flap delivers better functional and aesthetic results. METHOD: Between May 2014 and July 2016, 14 patients underwent reconstructive surgery after excision of axillary HS, 2 of them had bilateral lesion. In 15 cases TDAP was used, in 1 case we used thoracodorsal artery capillar perforator flap (TAPcp). RESULTS: In all but 2 cases 1 dominant perforator was found. 1 flap had 2 dominant perforators and 1 flap was supplied by capillary perforators. Size of the flaps spread between 6 × 8 and 10 × 15 cm. 15 reconstructions were successful, 1 flap necrotised because of the lack of compliance of the patient. CONCLUSION: As a result of the glandular tissue excision carried out because of a chronic HS, a deficiency emerges. TDAP flap is an ideal solution for surgical reconstruction of axillar deficiencies, and a great alternative to SSG.
Asunto(s)
Arterias/cirugía , Axila/irrigación sanguínea , Axila/cirugía , Hidradenitis Supurativa/cirugía , Colgajo Perforante/irrigación sanguínea , Procedimientos de Cirugía Plástica/métodos , Procedimientos Quirúrgicos Vasculares/métodos , Enfermedad Crónica , Hidradenitis Supurativa/clasificación , Humanos , Colgajos QuirúrgicosRESUMEN
INTRODUCTION: Handling problems in the head and neck region often requires a close cooperation between allied professions, just as in the challenging cases presented by us. Cases and methodology: With the first patient, we performed a radical surgery on the left side of the face due to recidivious basal cell carcinoma, followed by reconstruction using a Type I chimeric anterolateral thigh flap (ALT), while in the case of the second patient, we carried out a radical surgery on the right side of the face due to epithelial carcinoma and reconstruction with a Type I chimeric thoracodorsal flap. With our third patient, a reconstructive operation was performed due to left-sided congenital hemifacial microsomia, using a profunda artery perforator (PAP) flap. The fourth patient, due to the loss of the right hemi mandible as a result of an injury, went through a reconstructive procedure designed with Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM) technology, using a fibula free flap. RESULTS: All chosen reconstructive methods proved to be efficient and safe solutions in handling the problems. CONCLUSION: Through the cases presented, we intend to raise awareness of the importance of cooperation between maxillofacial and plastic surgery as well as of the ever-growing range of reconstructive opportunities through the flaps used.
Asunto(s)
Neoplasias de Cabeza y Cuello/cirugía , Cabeza/cirugía , Cuello/cirugía , Procedimientos de Cirugía Plástica/métodos , Cirugía Plástica/métodos , Colgajos Quirúrgicos , Muslo/irrigación sanguínea , Carcinoma/cirugía , Conducta Cooperativa , Femenino , Arteria Femoral/cirugía , Humanos , Hungría , Comunicación Interdisciplinaria , Masculino , Persona de Mediana Edad , Muslo/cirugía , Resultado del TratamientoRESUMEN
INTRODUCTION: Albeit there is decreasing tendency nowadays for stoma construction, if it still happens, parastomal herniation might occur in up to 50% of cases afterwards. One third of the cases requires surgical correction, not rarely as an emergency. The different methods of repair can be quite demanding and the complication rates are high. From 2003 we have started to use specially designed 3-dimensional meshes for the prevention and repair of parastomal hernias. METHODS: From 1st of January 2012 to 1st of June 2016 we have used these devices within the framework of a prospective, controlled, randomized study enrolling the patients in preventive and repair arms. Until now mesh was implanted for prevention at the time of the index operation in 38 cases, (control group: 46 cases), and for repair in 14 cases (control group: 18 cases). Recruitment of the patients will end in 2017. The operations were performed by laparoscopic approach in 22 cases and by open approach in 62 cases in the preventive arm, and 6/26 cases in the repair arm respectively. Mean follow up period is 19.2 months in the mesh group and 22.6 months in the non mesh group in the preventive arm, and 25.9/20.4 months in the repair arm respectively. RESULTS: No statistical analysis was used to interpret these interim results in this paper, we intend to analyze our results at the end of the study. At this stage apparently there is no difference between the group of patients in terms of complications in both arms. Parastomal herniation was found in 18 cases (39.1%) in the non mesh group and in 3 cases (7.8%) in the mesh group in the preventive arm. Recurrency was noted in 8 cases (44%) in the non mesh group, and in 1 case (7.1%) in the mesh group in the repair arm. CONCLUSIONS: Our results correlate with other studies where mesh insertion was used to prevent and/or repair parastomal hernias. We attribute these results mainly to the special, 3-dimensional design of the meshes used by us. This construction was developed based on understanding the patomechanism of parastomal hernia formation.
Asunto(s)
Hernia Ventral/cirugía , Laparoscopía/métodos , Mallas Quirúrgicas , Estomas Quirúrgicos/efectos adversos , Adulto , Colostomía , Femenino , Hernia Ventral/patología , Hernia Ventral/prevención & control , Humanos , Masculino , Complicaciones Posoperatorias/etiología , Estudios Prospectivos , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
AIM: Ulcerative colitis (CU) or Familiar Polyposis (FAP) can be the indication for proctocolectomy reconstructed with J pouch. The complete removal of the colon mucosa is essential regarding the late complications and at the same time the atraumatic surgical technique is very important concerning on the long term functional results. Both aspects seems to be answered by the stapled ileo-anal anastomosis using a "procedure for prolaps and haemorrhoids (PPH)" stapler applied by us since 2000. PATIENTS AND METHODS: 117 proctocolectomies reconstructed with J pouch and ileo-anal anastomosis were performed in our department between March 1990 and September 2016 indicated by CU or by FAP. In the first time period the ileo-anal anastomosis was sutured by hand (29 cases) and since 2000 the PPH stapler was applied as a routine (88 patients). Deviating ileostomy was performed in most cases of us. The data of the 117 patients were collected from the database of our hospital, 45 of them were interviewed personally and another 31 patients were contacted by phone, so 76 patients (65%) were eligible for follow-up. Frequency of stool, use of loperamid, level of incontinence (Wexner score) and perianal dermatitis were detected. The mean follow-up time was 18.6 years in the hand-sewn anastomosis group and 7.6 years in the PPH group. RESULTS: In the hand-sewn anastomosis group in 4/29 cases (13.8%) the removal of the pouch with definite ileostomy were necessary (2 pouchitis, 1 pouch necrosis, 1 recidiv rectum cancer); the mean stool frequency was 4.3 per day; the Wexner incontinence score was 8.5 and 2/15 patients (13.3%) live with ileostomy caused by incontinence. In the PPH stapled ileo-anal anastomosis group in 4/88 cases (4.5%) were the pouch removed (caused by pouchitis), the mean stool frequency was 4.0 per day; the Wexner score was 7.6 and 4/61 patients (6.6%) live with ileostomy caused by incontinence. CONCLUSIONS: Based on our experience the ileo-anal anastomosis performed by PPH stapler is technically feasible, seems to be effective concerning on the complete removal of the rectal mucosa and we observed better functional results compared with the hand-sewn anastomosis. Our data should be confirmed because of the low patients' volume.
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Canal Anal/cirugía , Colitis Ulcerosa/cirugía , Íleon/cirugía , Proctocolectomía Restauradora/métodos , Engrapadoras Quirúrgicas , Anastomosis Quirúrgica/efectos adversos , Anastomosis Quirúrgica/métodos , Reservorios Cólicos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Complicaciones Posoperatorias , Proctocolectomía Restauradora/efectos adversos , Grapado Quirúrgico/efectos adversosRESUMEN
OBJECTIVE: Esophageal resection is a traumatic intervention usually performed on patients with poor condition, resulting high mortality and morbidity. To improve the high incidence of complications, minimal invasive interventions were introduced. The results of the thoracoscopically and laparoscopically performed esophageal resection (McKeown) was investigated after 20 cases and the technical details of the surgical intervention are presented. PATIENTS AND METHOD: 20 thoracoscopic esophageal resection with laparoscopic gastric tube formation (sec. Akiyama) preparing the esophago-gastric anastomosis on the neck were performed in our department in the last four years. 1 patient with stricture and the other 19 patients with esophageal cancer were operated on, among them11 had T4 stage. 17 patient received neoadjuvant chemo-radiotherapy because of advanced disease. Regular follow up examinations were performed in the oncological outpatient department. RESULTS: 8 patients are alive after a mean follow up period of 25 months, 2 of them are treated oncologically because of recurrent disease. 19 patients were extubated within 12 hours after the intervention and the time spent in the intensive care unit were reduced to 1 or 2 days. The mean duration of the intervention was 320 minutes. Thoracoscopic dissection was performed in 8 patients without ventilation of the right lung using double lumen tracheal tube, among them 3 patients developed pneumonia in the postoperative period. The remaining 12 patients were operated with ventilated right lung, among them one patient developed pneumonia. One patient was converted because of injury of the thoracic aorta, after urgent thoracotomy we managed to suture the aortic wall. 1 patient died in 30 days after the operation, caused by leakage of the anastomosis, resulting mediastinitis and esophago-tracheal fistula. In two patients re-thoracoscopy and ligation of the thoracic duct was performed because of chylothorax refractory for conservative treatment. CONCLUSIONS: According to our observation the minimal invasive esophageal resection resulted in comparable oncological results with relevant reduction of mortality and morbidity compared to the open procedure. After procedures performed with ventilated lung further reduction of pulmonary complication was found. In case of tumors infiltrating the tracheal or the aortic wall, thoracotomy should be considered to explore the thoracic cavity and to carry out the dissection, if it is possible. Our results should be reinforced because of low number of patients.
Asunto(s)
Anastomosis Quirúrgica , Neoplasias Esofágicas/cirugía , Esofagectomía/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Anciano , Femenino , Humanos , Laparoscopía/métodos , Masculino , Terapia Neoadyuvante , Tempo Operativo , Toracoscopía , Resultado del TratamientoRESUMEN
INTRODUCTION: The prevalence of morbid obesity and its co-morbidities - first of all diabetes type 2 - increased dramatically in the last decades. As the conservative ways of treatment (diet, training, etc.) in most cases does not lead to effective and long term weight loss, there is an increasing need for the metabolic surgical interventions. METHOD: During the last 6 and half years 514 laparoscopic RouxY gastric bypass (LRYGB) and 54 laparoscopic gastric sleeve resection (LGSR) were performed in our department. The data of random selected 40 patients after primary LRYGB and 15 patients after sleeve resection were collected. The applied criteria of the indication for surgery, the routine examinations and treatments before and after the intervention, the results and the type and the rate of the complications will be presented. RESULTS: According to our experience both procedures are long term effective for weight loss and for the resolution of co-morbidities, and can be performed with low risk of complications. After LRYGB more effective weight loss (extra weight loss 88% vs. 68%) and higher rate of resolution of diabetes type 2, hypertension and gastro-esophageal reflux were found compared to sleeve resection. CONCLUSION: Based on our results we prefer LRYGB. Gastric sleeve resection is indicated by us, when there is no way - or only with high risk - to perform gastric bypass, taking into consideration of course the individual requirements of the patients.
Asunto(s)
Derivación Gástrica/métodos , Laparoscopía , Obesidad Mórbida/cirugía , Pérdida de Peso , Adulto , Índice de Masa Corporal , Comorbilidad , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Gastrectomía/métodos , Reflujo Gastroesofágico/epidemiología , Humanos , Hungría/epidemiología , Hipertensión/epidemiología , Laparoscopía/efectos adversos , Laparoscopía/métodos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Factores de Riesgo , Factores de Tiempo , Resultado del TratamientoRESUMEN
Massive localized lymphoedema (MLL) is a relatively frequent complication in obesity. MLL is present as a giant swelling and associated with characteristic skin changes. Due to the pathologic and morphologic similarity to sarcoma, MLL is also called "pseudosarcoma". MLL can degenerate into angiosarcoma without surgery. We present a case of MLL of the mons pubis in a 54-year-old man with a BMI of 48.6.
Asunto(s)
Vasos Linfáticos/fisiopatología , Linfedema/etiología , Linfedema/cirugía , Obesidad Mórbida/complicaciones , Procedimientos de Cirugía Plástica/métodos , Índice de Masa Corporal , Constricción Patológica/complicaciones , Constricción Patológica/etiología , Humanos , Vasos Linfáticos/patología , Linfedema/fisiopatología , Masculino , Persona de Mediana Edad , Presión , Hueso PúbicoRESUMEN
Current surgical treatment modalities for breast reconstruction include latissimus dorsi mycotaneous flap with immediate permanent breast implant (LDI). The aim of the present study was to analyze reconstruction with LDI in terms of quality of life, cosmesis and patient satisfaction. A chart analysis was carried out with the first ten patients who underwent breast reconstruction with LDI. The patients were interviewed and self-assessment quality of life was administered. They also underwent assessment of satisfaction and cosmesis. The high satisfaction and cosmesis scores in the breast reconstruction group indicate the superior results that can be achieved with breast reconstruction.
Asunto(s)
Implantes de Mama , Mamoplastia/métodos , Mamoplastia/psicología , Colgajo Miocutáneo , Satisfacción del Paciente/estadística & datos numéricos , Calidad de Vida , Músculos Superficiales de la Espalda/trasplante , Adulto , Belleza , Femenino , Humanos , Mastectomía Radical Modificada/psicología , Persona de Mediana Edad , Autoinforme , Encuestas y CuestionariosRESUMEN
BACKGROUND: Despite the well-known high donor site morbidity of the radial forarm flap, it has still remained the first option for the reconstruction of the tongue and the floor of mouth. However, a desire for an alternative, thin fasciocutaneous flap has led to the use of the median sural artery perforator flap. METHODS: Three patients had reconstructive surgery used MSAP flaps, after radical tumor excision. RESULTS: The flap was based in all cases on a dominant perforator vessel. The size of the skin paddles ranged between 20-32 cm2, and the length of the vascular pedicle between 8.2-11 cm. The mean thickness of the flap was 6.5 mm. CONCLUSION: MSAP flap is an ideal solution for surgical reconstruction in the oral cavity.
Asunto(s)
Pierna , Suelo de la Boca/irrigación sanguínea , Suelo de la Boca/cirugía , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Neoplasias de la Lengua/cirugía , Sitio Donante de Trasplante/irrigación sanguínea , Adulto , Anciano , Arterias/trasplante , Femenino , Antebrazo , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Procedimientos de Cirugía Plástica/efectos adversos , Neoplasias de la Lengua/irrigación sanguínea , Resultado del TratamientoRESUMEN
DIEP flap is a reliable option for autologous breast reconstruction after mastectomy. Previously performed lower median laparotomy can cause some difficulties in cases when more volume is needed than the DIEP flap harvested from one side can provide. We performed breast reconstruction using double hemi-DIEP flaps in three of the cases discussed. All patients recovered without complications and had a good aesthetic outcome. This method offers a safe opportunity and broadens the spectrum of breast reconstruction.
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Arterias Epigástricas/cirugía , Colgajos Tisulares Libres , Mamoplastia/métodos , Adulto , Neoplasias de la Mama/cirugía , Estética , Femenino , Humanos , Mastectomía Radical Modificada , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Perineal wound healing problems following extended abdomino-perineal resection of ano-rectal cancer represent a great challenge to the surgeon. Perineal soft-tissue reconstruction with a myocutan flap was thought to reduce surgical wound healing complications. A review of the relevant literature was carried out on perineal soft-tissue reconstruction with rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal rectal resection for cancer. The more commonly used neoadjuvant chemo- and radiotherapy as well as extended surgical radicality resulted in increased perioperative risks, therefore combined procedures between the colorectal and plastic surgical teams are inevitable. This case report illustrates the above trend.
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Adenocarcinoma/cirugía , Perineo/cirugía , Procedimientos de Cirugía Plástica/métodos , Neoplasias del Recto/cirugía , Recto del Abdomen/trasplante , Colgajos Quirúrgicos , Neoplasias del Ano/cirugía , Colostomía , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Humanos , Resultado del TratamientoRESUMEN
Centrally located breast cancers account for 5-20% of all breast cancer cases. Historically, patients with central breast cancers were not offered breast conservation surgery but conventional mastectomy only. The relatively frequent nipple-areola-complex involvement and consequent nipple-areolar resections with an adequate safety margin around the tumor usually result in an unacceptable cosmetic result. However, breast conservation surgery can be offered to these patients applyingoncoplastic surgical techniques. In this study, central quadrantectomy and breast reconstruction with Grisotti's dermo-glandular flap is evaluated.
Asunto(s)
Mamoplastia , Mastectomía Segmentaria , Neoplasias de la Mama , Humanos , Mastectomía , Colgajos QuirúrgicosRESUMEN
AIM: Treatment of sacral dermoid cysts (SDC) is a surgical challenge. Etiology and adequate operative technique of that are debated widely up to now, and recurrence rates remained high despite various surgical techniques applied. In cases of unsuccessfully operated and repeatedly recurrent SDC a fascio-cutaneous flap on the first perforating branch of the inferior gluteal artery (IGA) is a definitive procedure. MATERIAL AND METHOD: Following preparation and dissection of sidebranches of IGA in cadavers, a repeatedly recurrent SDC was operated. CONCLUSION: a flap harvested and transferred on the first superficial perforating branch(es) of the inferior gluteal artery offers a definitive and recurrence-free surgical solution for SDC.
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Quiste Dermoide/cirugía , Arteria Ilíaca/trasplante , Sacro , Neoplasias de la Columna Vertebral/cirugía , Colgajos Quirúrgicos/irrigación sanguínea , Adulto , Nalgas/irrigación sanguínea , Quiste Dermoide/etiología , Humanos , Masculino , Recurrencia , Neoplasias de la Columna Vertebral/etiología , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
Microsurgical transplantation of the osteo-cutaneous fibula as a free flap to reconstruct the defect following radical resection of a mouth floor's tumor is a well-known and often applied procedure. Anatomy of the vessels supplying this flap is recognized but it may have some rare and unexpected variations. In this case report we discuss the reconstruction of the middle and lateral parts of the mandible which was resected due to a T4 gingival tumor. Interestingly, the aforementioned segment of the fibula and the overlying skin island were supplied by different pedicles, both emerging from the posterior tibial vessels. Both flaps were transplanted using autologous arterial and venous grafts of the peroneal artery and vein in case of the fibula. We believe this case is worth publishing due to its relative rarity in the literature and the applied surgical method.
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Peroné/trasplante , Colgajos Tisulares Libres/irrigación sanguínea , Neoplasias Gingivales/cirugía , Mandíbula/cirugía , Suelo de la Boca/cirugía , Procedimientos de Cirugía Plástica/métodos , Trasplante de Piel/métodos , Arterias Tibiales/trasplante , Peroné/irrigación sanguínea , Humanos , Masculino , Persona de Mediana Edad , Trasplante Autólogo , Resultado del TratamientoRESUMEN
Soft tissue defect of the sole is usually a quite challenging problem. In this case report the most frequently used reconstructive options of this problem are reviewed paying particular attention for the well applicable and reliable types. An ALT graft as a free flap to the sole offers a good possibility for coverage, which is resistant enough to mechanic strains.
Asunto(s)
Talón/patología , Talón/cirugía , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos , Muslo/cirugía , Humanos , Masculino , Persona de Mediana Edad , Necrosis/etiología , Necrosis/cirugía , Trasplante AutólogoRESUMEN
INTRODUCTION: Laparosocopic splenectomy gradually became the gold standard procedure in the surgical treatment of certain haematological disorders. Operative experience in laparoscopic procedures facilitates the comparison of various techniques. AIM: Two variants in laparoscopic spelenectomy are analysed and presented. MATERIAL AND METHOD: Sixteen patients underwent laparoscopic spelenectomy. Anterior- and postero-anterior laparoscopic approaches are compared with respect to clinicopathologic features. CONCLUSIONS: Using the postero-anterior technique dissection of splenic hilum is more straightforward, recognition of accessory spleen is easier and the likelihood of intraoperative complications is less. In selected cases of splenomegaly the anterior technique is recommended though.
Asunto(s)
Laparoscopía , Esplenectomía/métodos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esplenectomía/efectos adversos , Resultado del TratamientoRESUMEN
Recurrent subareolar abscess is an uncommon benign disease of the breast, which is caused by peri-ductal mastitis with various etiology. Radical surgical procedure is necessary for cure instead of inadequate courses of antibiotics or incisions. In some cases the use of the pectoral muscle sling flap can be an alternative technique for the treatment of recurrent subareolar abscess after repeated standard surgical treatment. A 36 year old woman, who successfully underwent this procedure, is presented here.
Asunto(s)
Absceso/cirugía , Enfermedades de la Mama/cirugía , Músculos Pectorales/cirugía , Colgajos Quirúrgicos , Absceso/etiología , Adulto , Femenino , Humanos , Pezones , Reoperación , Resultado del TratamientoRESUMEN
BACKGROUNDS/AIMS: The present study was designed to provide an analysis of factors for tumor vascularisation and proliferation in 37 rectal cancer patients with concurrent and recurrent liver metastasis underwent preoperative radiotherapy, surgery and adjuvant chemotherapy with emphasis on the time of presence of hepatic spread. METHODOLOGY: Immunohistochemistry was used for expression of proliferation (MIB-1) and for detection of microvessel density (MVD, expressed by CD34). Clinicopathological findings were compared with outcome with emphasis on IHC. RESULTS: A vascular enumeration, pN status and the time of presence of the metastases has shown prognostic role along with the factors above. Increased proliferative activity of the tumor as expressed by MIB-1 staining had no prognostic value, similarly to the localization of tumor, gender, age or grading. CONCLUSION: Higher pN status and tumor vascularisation has been linked to poor prognosis in overall survival and recurrence of liver metastases.