Modified median hepatic fissure approach for resection of liver tumours located in the angle between the root of the middle and right hepatic veins

Abstract Background Liver tumours between the root angle of the middle and right hepatic veins are a special type of liver segment VIII tumour. In this study, we designed a modified median hepatic fissure approach to remove these tumours. The safety and effectiveness of the approach were evaluated. Materials and methods From April 2015 to November 2019, 11 patients with liver tumours between the angle of the middle and right hepatic veins underwent this modified median hepatic fissure approach. We retrospectively analysed data from the perioperative periods of these 11 patients, including general condition, operation time, intraoperative bleeding, and postoperative complications. Disease-free survival and overall survival were assessed. Results Of the 11 patients, 9 patients had primary hepatocellular carcinoma and 2 had colorectal liver metastases. The average intraoperative blood loss was 285 mL (150–450 mL). Two patients developed postoperative bile leakage, but there were no significant serious complications, such as intraabdominal bleeding and liver failure, in any of the patients. The liver function returned to the normal range on the 5th day after surgery. Of the 11 patients, 5 have survived for more than 3 years (45.5%), and 4 have been disease-free for more than 3 years (36.3%). Conclusions For liver tumours between the root angle of the middle and right hepatic veins, the modified median hepatic fissure approach is a safe and feasible method.

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Reconstruction With 3D-Printed Prostheses After Sacroiliac Joint Tumor Resection: A Retrospective Case-Control Study

Frontiers in Oncology ◽

10.3389/fonc.2021.764938 ◽

2022 ◽

Vol 11 ◽

Author(s):

Feifei Pu ◽

Jianxiang Liu ◽

Deyao Shi ◽

Xin Huang ◽

Jingtao Zhang ◽

...

Keyword(s):

Sacroiliac Joint ◽

Tumor Resection ◽

Disease Free Survival ◽

Operation Time ◽

Control Group ◽

Intraoperative Bleeding ◽

Free Survival ◽

3D Printed ◽

Disease Free

BackgroundSacroiliac joint tumor is rare, and the reconstruction after tumor resection is difficult. We aimed to analyze and compare the clinical effects of three-dimensional (3D) printed prostheses and bone cement combined with screws for bone defect reconstruction after sacroiliac joint tumor resection.MethodsTwelve patients with sacroiliac joint tumors who underwent tumor resection and received 3D-printed prostheses to reconstruct bone defects in our hospital from January 2014 to December 2020 were included in the study group Twelve matched patients who underwent sacroiliac joint tumor resection and reconstruction with bone cement and screws in the same time period were selected as the control group.ResultsIn the 3D-printing group, six cases were extensively excised, and six cases were marginally excised. All patients were followed up for 6–90 months, and the median follow-up time was 21 months. Among them, nine patients had disease-free survival, two survived with tumor recurrence, and one died due to tumor metastasis. The MSTS-93 score of the surviving patients was 24.1 ± 2.8. The operation time was 120.30 ± 14.50 min, and the intraoperative bleeding was 625.50 ± 30.00 ml. In the control group, seven cases were extensively excised, and five cases were marginally excised. All patients were followed up for 6–90 months, with a median follow-up time of 20 months. Among them, nine patients had disease-free survival, one survived with tumor recurrence, and two died due to tumor metastasis. The MSTS-93 score of the patients was 18.9 ± 2.6. The operation time was 165.25 ± 15.00 min, and the intraoperative bleeding was 635.45 ± 32.00 ml. There was no significant difference in survival status, intraoperative blood loss, or complications between the two groups (P>0.05). However, there were statistically significant differences in operative time and postoperative MSTS-93 scores between the two groups (P<0.05).ConclusionsAfter resection of the sacroiliac joint tumor, reconstruction using 3D printed prostheses was shorter and resulted in better movement function.

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Meta-Analysis on the Efficacy and Safety of Laparoscopic Surgery for Large Gastric Gastrointestinal Stromal Tumors

The American Surgeon ◽

10.1177/0003134820951482 ◽

2020 ◽

pp. 000313482095148

Author(s):

Miao Yu ◽

Deng-chao Wang ◽

Jian Wei ◽

Yue-hua Lei ◽

Zhao-jun Fu ◽

...

Keyword(s):

Gastrointestinal Stromal Tumors ◽

Laparoscopic Resection ◽

Meta Analysis ◽

Disease Free Survival ◽

Operation Time ◽

Intraoperative Blood Loss ◽

Open Resection ◽

Free Survival ◽

Stromal Tumors ◽

Disease Free

Background The aim of this study was to conduct a meta-analysis comparing the safety and feasibility of laparoscopic versus open resection for gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm. Method We searched the Cochrane Library, PubMed, and Embase for relevant articles. Randomized and nonrandomized clinical trials were identified and included in this study. Searching for related articles on large GIST (>5 cm) for laparoscopic resection (laparoscopic group [LAPG]) and open resection (open group [OG]), RevMan 5.3 was used for data analysis, comparing 2 groups of operation time, intraoperative blood loss, complications, length of hospital stay, recurrence rate, disease-free survival, and overall survival. Results Seven studies including 440 patients were identified for the meta-analysis. Meta-analysis revealed that LAPG had less bleeding, shorter postoperative hospital stay, and a better 5-year disease-free survival. There was no significant difference between LAPG and OG in operation time, postoperative complications, recurrence rate, and overall survival. Conclusion Laparoscopic resection of large (>5 cm) GIST is safe and feasible and has the advantages of less intraoperative blood loss and fast postoperative recovery, with a good outcome in the recent oncology.

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Laennec’s approach for laparoscopic anatomical hemihepatectomy

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02404-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Wei Hu ◽

Gongming Zhang ◽

Meng Chen ◽

Chengcheng Zhong ◽

Mingxu Li ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Primary Liver Cancer ◽

Surgical Techniques ◽

Operation Time ◽

Bile Leakage ◽

Hepatic Veins ◽

Hepatic Hemangioma ◽

Conversion To Open Surgery ◽

The Mean

Abstract Background Laennec’s capsule has been found for about 200 years. However, laparoscopic anatomical right and left hemihepatectomy (LARH and LALH) using Laennec’s approach are rarely reported. Methods We retrospectively analyzed the technical details and the surgical outcomes of 15 patients who underwent LAH via Laennec’s approach between May 2017 and July 2020. The operation time, intraoperative blood loss, postoperative complications, and hospital stay were recorded and analyzed. Results Four of 15 patients were diagnosed with hepatic hemangioma, 2 had hepatolithiasis, and 9 patients had primary liver cancer. During the surgery, Laennec’s approach was used for LAH without conversion to open surgery. Four patients were treated with LARH, and 11 patients were cured with LALH. The mean age of the patients was 62.1 ± 6.5 years, and four were male. The mean operative time, blood loss, and length of the postoperative hospital stay were 193 ± 49 min, 247 ± 120 mL, and 8.7 ± 2.0 days, respectively. There was no incidence of postoperative bile leakage and bleeding. No mortality occurred. We also demonstrated that Laennec’s capsule does exist around the peripheral hepatic veins with histological confirmation. Conclusions Laennec’s approach is safe and feasible for LAH. Precise isolation of Laennec’s approach based on Laennec’s capsule helps to standardize the surgical techniques for laparoscopic anatomical hepatectomy.

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Laennec's Approach for Laparoscopic anatomical Hemihepatectomy

10.21203/rs.3.rs-290569/v1 ◽

2021 ◽

Author(s):

Wei Hu ◽

Gongming Zhang ◽

Meng Chen ◽

Chengcheng Zhong ◽

Mingxu Li ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Primary Liver Cancer ◽

Surgical Techniques ◽

Operation Time ◽

Bile Leakage ◽

Hepatic Veins ◽

Hepatic Hemangioma ◽

Conversion To Open Surgery ◽

Histological Confirmation

Abstract Background: Laennec's capsule has been found for about 200 years. However, laparoscopic anatomical right and left hemihepatectomy (LARH and LALH) using the Laennec's approach are rarely reported. Methods: We retrospectively analyzed the technical details and the surgical outcomes of 15 patients who underwent LAH via Laennec's approach between May 2017 and July 2020. The operation time, intraoperative blood loss, postoperative complications, and hospital stay were recorded and analyzed. Results: 4 of 15 patients were diagnosed with hepatic hemangioma, 2 had hepatolithiasis, and 9 patients had primary liver cancer. During the surgery, Laennec's approach was used for LAH without conversion to open surgery. 4 patients were treated with LARH and 11 patients were cured with LALH. The operative time, blood loss, and hospital stay were 193 ± 49 min, 247 ± 120 mL and 8.7 ± 2.0 days, respectively. There was no incidence of postoperative bile leakage and bleeding. No mortality occurred. We also demonstrated that Laennec's capsule does exist around the peripheral hepatic veins with histological confirmation. Conclusions: Laennec's approach is safe and feasible for LAH. Precise isolation of Laennec's approach based on Laennec's capsule helps to standardize the surgical techniques for laparoscopic anatomical hepatectomy.

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Long Term Survival Analysis of Hepatectomy for Neuroendocrine Tumour Liver Metastases

The Scientific World JOURNAL ◽

10.1155/2014/524045 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Tan To Cheung ◽

Kenneth S. H. Chok ◽

Albert C.Y. Chan ◽

Simon Tsang ◽

Jeff W. C. Dai ◽

...

Keyword(s):

Liver Metastases ◽

Neuroendocrine Tumour ◽

Treatment Strategies ◽

Disease Free Survival ◽

Operation Time ◽

Morbidity Rate ◽

Term Survival ◽

One Year ◽

Disease Free

Background.Liver is the commonest site for metastasis in patients with neuroendocrine tumour (NET). A vast majority of treatment strategies including liver directed nonsurgical therapy, liver directed surgical therapy, and nonliver directed therapy have been proposed. In this study we aim to investigate the outcome of liver resection in neuroendocrine tumour liver metastases (NELM).Method.293 patients had hepatectomy for liver metastasis in our hospital between June 1996 and December 2010. Twelve patients were diagnosed to have NET in their final pathology and their data were reviewed.Results.The median ages of the patients were 48.5 years (range 20–71 years). Eight of the patients received major hepatectomy. Four patients received minor hepatectomy. The median operation time was 418 minutes (range 195–660 minutes). The median tumor size was 8.75 cm (range 0.9–21 cm). There was no hospital mortality. The overall one-year and three-year survivals were 91.7% and 55.6%. The one-year and three-year disease-free survivals were 33.3% and 16.7%.Conclusion.Hepatectomy is an effective and safe treatment for NELM. Reasonable outcome on long term overall survival and disease-free survival can be achieved in this group of patients with a low morbidity rate.

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Ứng dụng dao siêu âm Sonastar trong phẫu thuật cắt gan

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2020.65.19 ◽

2020 ◽

Author(s):

Hien Pham Nhu

Keyword(s):

Liver Resection ◽

Blood Loss ◽

Operative Time ◽

Resection Margin ◽

Operation Time ◽

Bile Leakage ◽

Hepatic Veins ◽

Early Results ◽

Solitary Liver ◽

The Mean

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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Safety of Simultaneous Hepatectomy and Splenectomy in the Treatment of Hepatocellular Carcinoma Complicated with Hypersplenism: A Meta-analysis

Gastroenterology Research and Practice ◽

10.1155/2019/9065845 ◽

2019 ◽

Vol 2019 ◽

pp. 1-17

Author(s):

Xuefeng Liu ◽

Zhiqiang Chen ◽

Meng Yu ◽

Wei Zhou ◽

Xuting Zhi ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Meta Analysis ◽

Disease Free Survival ◽

Operation Time ◽

Cochrane Library ◽

Perioperative Mortality ◽

Free Survival ◽

Newcastle Ottawa Scale ◽

Disease Free ◽

Ottawa Scale

Background. We conducted this meta-analysis to compare the efficacy and safety of simultaneous hepatectomy and splenectomy (HS) with hepatectomy alone (HA) in patients with hepatocellular carcinoma (HCC) and hypersplenism. Materials and Methods. A systematic search was conducted in PubMed, Embase, Cochrane Library, and Wanfang Data through March 1, 2018, with no limits. Two investigators independently screened all retrieved studies. The investigators of the original publications were contacted if required information was absent. All the included studies were managed by EndNote X7. Quality assessment of the included studies was performed using a modified Newcastle-Ottawa Scale judgment. Extracted data for each endpoint were analyzed by using STATA 12.0 software. Results. Thirteen studies, including a total of 1468 patients, comparing the effects of HS with HA were pooled in this meta-analysis. Outcomes including postoperative complications, perioperative mortality, intraoperative blood transfusion, and albumin (ALB) content at postoperation day (POD) 7 did not differ significantly between the two groups. Simultaneous approaches significantly promoted 1-, 3-, and 5-year disease-free survival (DFS) rates and overall survival (OS) rates, prolonged operation time, aggravated intraoperative blood loss, increased white blood cell (WBC) and platelet (PLT) counts at POD 7, and lowered total bilirubin (T-Bil) contents at POD 1 and 7. Conclusion. Compared to HA, HS is safer and more effective in ameliorating liver function and improving survival of HCC patients complicated with hypersplenism. This trial is registered with CRD42018093779.

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