Early Results after Radiofrequency-Assisted Liver Resection

Background: Researching specification and evaluating early results after hepatectomy that it’s used with Sonastar ultrasonic tool. Materials and methods: We prospectively examined data of 19 patients who underwent hepatectomy at Hue Central Hospitalfrom 7/2019to 7/2020. Results: The mean ages was 60,7 ± 10,5 range (19 – 90) and males/females was 6:1.. Patients with solitary liver tumor accounted for 79%; while tumors that have satellite cores accounted for 21% of all cases. 68,4% of all patients have tumor that is more than 5cm in size. Blocking hepatic blood flow by clamping of hepatoduodenal ligament accounts for 57,9%, while right and left hepatic vein clamp accounted for 68,4% and 36,8% respectively. In 78,9% of the cases, surgicel was used to cover the liver resection margin, while the in the remainder 21,5% of the cases, BioGlue was used. Large liver resection (2 and more lobes resected) accounted for 73,7% of all cases. Mean liver resection time was 50 ( 45-110) minutes, mean operation time was 125 (90-280) minutes, mean blood loss amount was 250 (150-650)ml. On average, post-operative time was 8 days (7-23). Post-operative complications was observed in 15,9% of cases, and there was 5,3% deceased. Conclusion: Application of Sonastar ultrasonic tool in hepatectomy reduces blood loss, help better manage hepatic veins, thus reducing complications such as bile leakage. It also helps surgeons manage the liver resection margin, minimalizing recurrences cancer

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Early results of liver resection using laparoscopic technique

Polish Journal of Surgery ◽

10.1515/pjs-2016-0022 ◽

2016 ◽

Vol 88 (1) ◽

Author(s):

Maciej Stanek ◽

Michał Pędziwiatr ◽

Dorota Radkowiak ◽

Anna Zychowicz ◽

Piotr Budzyński ◽

...

Keyword(s):

Liver Resection ◽

Gall Bladder ◽

Radical Resection ◽

The Other ◽

Laparoscopic Technique ◽

Focal Lesions ◽

Liver Malignancy ◽

Excessive Bleeding ◽

Liver Resections ◽

Early Results

Abstractwas to present early outcomes of liver resection using laparoscopic technique.Retrospective analysis of patients who underwent liver resection using laparoscopic method was conducted. The analyzed group included 23 patients (11 women and 12 men). An average patient age was 61.3 years (37 – 83 years). Metastases of the colorectal cancer to the liver were the cause for qualification to the procedure of 15 patients, metastasis of breast cancer in 1 patient and primary liver malignancy in 5 patients. The other 2 patients were qualified to the liver resection to widen the surgical margins due to gall-bladder cancer diagnosed in the pathological assessment of the specimen resected during laparoscopic cholecystectomy, initially performed for other than oncology indications.Hemihepatectomy was performed in 11 patients (9 right and 2 left), while the other 12 patients underwent minor resection procedures (5 metastasectomies, 4 nonanatomical liver resections, 1 bisegmentectomy, 2 resections of the gall-bladder fossa). An average duration of the surgical procedure was 275 minutes 65 – 600). An average size of the resected tumors was 28 mm (7 – 55 mm). In three cases conversion to laparotomy occurred, caused by excessive bleeding from the liver parenchyma. Postoperative complications were found in 4 patients (17.4%). Median hospitalization duration was 6 days (2 – 130 days). One patient (4.3%) was rehospitalized due to subhepatic abscess and required reoperation. Histopathology assessment confirmed radical resection (R0) in all patients in our group.Laparoscopic liver resections seem to be an interesting alternative in the treatment of focal lesions in the liver.

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Early results of liver resection due to metastases of colorectal carcinoma

Vojnosanitetski pregled ◽

10.2298/vsp0805359k ◽

2008 ◽

Vol 65 (5) ◽

pp. 359-363

Author(s):

Radenko Koprivica ◽

Bozina Radevic ◽

Goran Tosovic ◽

Ranka Koprivica ◽

Radmila Smiljanic

Keyword(s):

Liver Resection ◽

Colorectal Carcinoma ◽

Liver Metastases ◽

Average Duration ◽

Color Doppler ◽

Morbidity Rate ◽

Cell Saver ◽

Oncologic Surgery ◽

Liver Resections ◽

Early Results

Background/Aim. Liver metastases are most frequently the result of colorectal carcinoma. The aim of this study was to analyse early results of operative treatment of the patients with the liver metastases of colorectal carcinoma. Methods. This retrospective, prospective study included 387 patients with colorectal carcinoma operated during the period from 2005-2007. All the patients were submitted to oncologic surgery protocol. The functional state of the liver was assessed, especially in the patients with hemotherapy. Diagnostic protocol further included color Doppler ultrasonography of the liver and port system, as well as spiral computed tomography includy angiography. Nine (5.7%) of the patients were submitted to explorative laparotomy. Results. Of all the patients 157 (40.6%) had metastases in the liver, synhronous 78 (20.15%) and metachronous 79 (20.45%), Forty two (26.7%) patients were indicated for the liver resection. In 33 (21%) of them it was performed successfully. There were 18 females and 15 males of the average age 60.09 (42-81) years. Up to 4 metastases had 90.9% of the patients and in 9.09% had up to 5 and more metastases. On average, metastases occupied 2.6 of the liver segments. There were 21.2% of solitary lesions (7 patients), 63.6% of multilple unilobular (21 patients) and 15.15% of multiple bilobular metastases (5 patients). Liver resection was done using ultraharmonic scalpel. At spacious liver resections we used a device for intraoperative saving of blood (cell saver) and applied a technique of selective hepatic vascular exclusion. An average disease-free interval was 16.7 months. There were 60.6% of anatomical liver resections and 39.4% of atypical resections. In 31.1% of the operated patients we made resection on up to two segments of the liver and in 30.3% we made resection of four segments. An average number of segments where resection had been performed was 2.65 and the duration of operation was 143 minutes. In 39.4% of the cases we used a technique of liver vascular isolation, an average duration was 38 minutes. In 30.3% of resections we used cell saver and 70% of operated patients were transfused. On average, 493 ml of blood was transfused. Of the total number of resections, 90.9% was of the type R0, 9.09% of the type R1. An average duration of postoperative hospitalization was 10.6 days. Operative morbidity rate was 15.15% and operative mortality 3.03%. During a six-month observing there were not any mortality or repeated metastases in liver. Conclusion. Anatomic liver resection including selective vascular hepatic excision by the use of an ultraharmonic scalpel and cell saver is considered to be efficient and secure method for the reduction of intraoperative and postoperative complications rendering good surgical results.

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Early Results of Liver Resection and Role of Extended Histology (LIREcH) Study

HPB ◽

10.1016/j.hpb.2020.11.296 ◽

2021 ◽

Vol 23 ◽

pp. S123

Author(s):

U. Mathuram Thiyagarajan ◽

R. Brown ◽

N. Chatzizacharias ◽

D. Bartlett ◽

R. Sutcliffe ◽

...

Keyword(s):

Liver Resection ◽

Early Results ◽

Results Of Liver Resection

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Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2003.julaug02 ◽

2003 ◽

Vol 8 (4) ◽

pp. 4-5

Author(s):

Christopher R. Brigham ◽

James B. Talmage

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Proper Time ◽

Carpal Tunnel Release ◽

Hand Function ◽

Factors Affecting ◽

Early Results ◽

Medical Evaluation ◽

Nerve Recovery ◽

Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

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Liver Resection for Liver Metastasis - the Bernese Results

Swiss Surgery ◽

10.1024/1023-9332.6.4.164 ◽

2000 ◽

Vol 6 (4) ◽

pp. 164-168 ◽

Cited By ~ 3

Author(s):

Seiler ◽

Redaelli ◽

Schmied ◽

Baer ◽

Büchler

Keyword(s):

Liver Resection ◽

Liver Metastasis ◽

Chirurgische Resektion ◽

Kurative Therapie

Neue Erkenntnisse über die Anatomie und Funktion der Leber haben dazu geführt, dass heute die chirurgische Resektion die Therapie der Wahl bei Lebermetastasen geworden ist. Obschon Lebermetastasen ein fortgeschrittenes Tumorstadium bedeuten, werden infolge besserer Kenntnisse der Karzinogenese (Mikrometastasen etc.) sowie der prognostischen Risikofaktoren erwiesenermassen die besten Langzeitresultate durch die chirurgische Resektion erzielt. In dieser Studie wurden die Ergebnisse von 109 Resektionen von kolorektalen sowie nicht kolorektalen Lebermetastasen an unserer Klinik während eines Zeitraumes von 59 Monaten zusammengefasst. Vier verschiedene Operationsverfahren (formelle Hemihepatektomie vs Segmentresektion vs atypische Resektion vs Biopsie) wurden untersucht. Die Einhaltung eines Resektionsabstandes von mindestens 10 mm wurde bei Resektionen immer angestrebt. Die kumulierte Morbidität aller Operationsverfahren zusammen betrug 23%. Obwohl die Morbidität bei ausgedehnten Resektionen höher war (Encephalopathie 16% vs 2.3% bei der Segmentresektion, Leberinsuffizienz 23% vs 4.7%), war das Langzeitüberleben gegenüber den limitierten Resektionsverfahren verbessert. Die 60-Tage Mortalität lag bei 2.7%. Patienten nach Resektion von kolorektalen Lebermetastasen hatten eine höhere Ueberlebensrate als diejenigen nach Resektion nicht kolorektaler Metastasen. Unsere Resultate zeigen, dass die Leberresektion heutzutage unter Einhaltung der anatomischen sowie funktionellen Grenzen (inkl. eines adäquaten Resektionsrandes) die einzige, potentiell kurative Therapie von Lebermetastasen darstellt. Trotz erhöhter perioperativer Morbidität ist die ausgedehnte formelle Resektion den limitierten Operationsverfahren bezüglich Langzeitüberleben überlegen. Ein Grund dafür ist die erhöhte Wahrscheinlichkeit einer Mitresektion von präoperativ nicht detektierbaren lokalen Mikrometastasen.

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