Ex-situ hepatectomy: Indications, Techniques and Results

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Danilo Coco ◽  
Silvana Leanza
Keyword(s):  
Liver Tumors ◽  
Vascular Reconstruction ◽  
Global Scale ◽  
The Body ◽  
Ex Situ ◽  
Preservation Solution ◽  
Hemodynamic Management ◽  
Primary Liver Tumors ◽  
Novel Approach ◽  
Infected Liver

Ex situ hepatectomy is a novel approach, used in treating complicated liver tumors, which are otherwise unresectable via conventional methods including organ perfusion, liver transplant, hemodynamic management, vascular reconstruction or even extended hepatic resection. The Ex situ hepatectomy technique denotes the entire removal of the infected liver, which is then perfused in a cold preservation solution, which allows the surgeon to remove tumors, which were otherwise unreachable when the liver is situated in the body. In so doing, the tumor is restricted ex situ on the surgeon stable, while the remaining liver is implanted orthotopically. Notably, the works on Ex situ hepatectomy techniques are credited to Pichlmary 1990, who proposed the surgical approach in the treatment of bilateral liver leiomyosarcoma. More to that, there are only a handful of successful Ex situ hepatectomy cases which have been recorded on a global scale, given the complexity of the operation. Secondary as well as primary liver tumors are some of the most commonly occurring liver tumors in  humans.

Eight years after introducing liver resection at the Oncology Institute of Vojvodina

2013 ◽  
Vol 21 (3-4) ◽  
pp. 101-104
Author(s):  
Ivan Majdevac ◽  
Nikola Budisin ◽  
Milan Ranisavljevic ◽  
Dejan Lukic ◽  
Imre Lovas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Liver Tumors ◽  
Liver Parenchyma ◽  
Malignant Neoplasms ◽  
Chemotherapy Treatment ◽  
Primary Liver Tumors ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases ◽  
Medical Histories

Background: Hepatectomies are mostly performed for the treatment of hepatic benign or malignant neoplasms, intrahepatic gallstones, or parasitic cysts of the liver. The most common malignant neoplasms of the liver are metastases from colorectal cancer. Anatomic liver resection involves two or more hepatic segments, while non-anatomic liver resection involves resection of the metastases with a margin of uninvolved tissue. The aim of this manuscript was to show results of hepatectomies performed at the Oncology Institute of Vojvodina. Methods: We performed 133 liver resections from January 1997 to December 2013. Clinical and histopathological data were obtained from operative protocols, histopathological reports, and patients? medical histories. Results: We did 80 metastasectomies, 51 segmentectomies, and 18 radiofrequent ablations (RFA). Average number of colorectal cancer metastases was 1.67 per patient. We also made 10 left hepatectomies. In all cases, we made non-anatomic resections. Conclusion: Decision about anatomic versus non-anatomic resections for colorectal metastasis and primary liver tumors should be made before surgical exploration. Preservation of liver parenchyma is important with respect to liver failure and postoperative chemotherapy treatment.

Rearrangement of a common cellular DNA domain on chromosome 4 in human primary liver tumors.

1988 ◽  
Vol 62 (2) ◽  
pp. 629-632 ◽  
Author(s):  
C Pasquinelli ◽  
F Garreau ◽  
L Bougueleret ◽  
E Cariani ◽  
K H Grzeschik ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Chromosome 4 ◽  
Primary Liver Tumors ◽  
Cellular Dna

scholarly journals Vascular Involvements in Cholangiocarcinoma: Tips and Tricks

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3735
Author(s):  
Roberta Angelico ◽  
Bruno Sensi ◽  
Alessandro Parente ◽  
Leandro Siragusa ◽  
Carlo Gazia ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Vena Cava ◽  
High Volume ◽  
Vascular Reconstruction ◽  
Ex Situ ◽  
Vascular Involvement ◽  
Hepatic Veins ◽  
Hepatic Artery Resection ◽  
Artery Resection

Cholangiocarcinoma (CCA) is an aggressive malignancy of the biliary tract. To date, surgical treatment remains the only hope for definitive cure of CCA patients. Involvement of major vascular structures was traditionally considered a contraindication for resection. Nowadays, selected cases of CCA with vascular involvement can be successfully approached. Intrahepatic CCA often involves the major hepatic veins or the inferior vena cava and might necessitate complete vascular exclusion, in situ hypothermic perfusion, ex situ surgery and reconstruction with autologous, heterologous or synthetic grafts. Hilar CCA more frequently involves the portal vein and hepatic artery. Resection and reconstruction of the portal vein is now considered a relatively safe and beneficial technique, and it is accepted as a standard option either with direct anastomosis or jump grafts. However, hepatic artery resection remains controversial; despite accumulating positive reports, the procedure remains technically challenging with increased rates of morbidity. When arterial reconstruction is not possible, arterio-portal shunting may offer salvage, while sometimes an efficient collateral system could bypass the need for arterial reconstructions. Keys to achieve success are represented by accurate selection of patients in high-volume referral centres, adequate technical skills and eclectic knowledge of the various possibilities for vascular reconstruction.

scholarly journals Making sense of farmers’ demand for seed of root, tuber and banana crops: a systematic review of methods

Food Security ◽  
2021 ◽  
Author(s):  
Thomas Pircher ◽  
Conny J. M. Almekinders
Keyword(s):  
Systematic Review ◽  
Classification Scheme ◽  
Agricultural Research ◽  
Global Scale ◽  
The Body ◽  
Decision Makers ◽  
Seed Systems ◽  
Making Sense ◽  
Root Tuber ◽  
Agricultural Research And Development

AbstractA demand-driven approach is becoming increasingly central in the efforts to improve agricultural research and development. However, the question of how exactly demand is studied usually remains unstated and is rarely discussed. We therefore carried out a systematic review in order to better understand how farmers’ demand for seed in root, tuber and banana seed systems is studied. The review is based on data from a consultation with an expert panel and a structured literature search in the SCOPUS database. Screening the gathered articles resulted in 46 studies on a global scale, fitting the scope of our investigation. Through qualitative analysis and categorization of these studies, we developed a classification scheme according to the types of approaches applied in the retained studies. One group of studies explicitly articulates farmers’ preferences and choices through surveys or engagements in trials, auctions, choice experiments and interviews. Other studies implicitly articulate farmers’ demand by characterising their current use of varieties and seed. We discuss opportunities and limitations in the use of each type of study and we reflect on the body of available literature as a whole. Our conclusion is that a framework is necessary that purposefully combines the existing different methods and that it is necessary to involve stakeholders in a process where demand is articulated. Together, these two steps would characterise existing demands in a more effective and precise way, thus providing better guidance to decision-makers in their reactions pertaining to seed systems.

Orthotopic liver transplantation in primary liver tumors

1993 ◽  
Vol 53 (S3) ◽  
pp. 74-77 ◽  
Author(s):  
Enrique Moreno-González ◽  
Carmelo Loinaz ◽  
Ramon Gómez ◽  
Ignacio Garclá ◽  
Ignacio González-Pinto ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Liver Tumors ◽  
Primary Liver Tumors

Lipidomics reveals perturbations in the liver lipid profile of iron overloaded mice

Metallomics ◽  
2021 ◽  
Author(s):  
Haoxuan Ding ◽  
Qian Zhang ◽  
Xiaonan Yu ◽  
Lingjun Chen ◽  
Zhonghang Wang ◽  
...  
Keyword(s):  
Iron Overload ◽  
Iron Status ◽  
Liver Lipid ◽  
Density Lipoprotein ◽  
Global Scale ◽  
The Body ◽  
Control Group ◽  
Sod Activity ◽  
Liver Iron ◽  
Iron Storage

Abstract Iron overload is an important contributor to disease. The liver, the major site of iron storage in the body, is a key organ impacted by iron overload. While several studies have reported perturbations in liver lipids in iron overload, it is not clear, on a global scale, how individual liver lipid ions are altered. Here, we used lipidomics to study the changes in hepatic lipid ions in iron-overloaded mice. Iron overload was induced by daily intraperitoneal injections of 100mg/kg body weight iron dextran for one week. Iron overload was verified by serum markers of iron status, liver iron quantitation, and Perls’ stain. Compared with the control group, the serum of iron-overload mice exhibited low levels of urea nitrogen and high-density lipoprotein (HDL), and high concentrations of total bile acid, low-density lipoprotein (LDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH), suggestive of liver injury. Moreover, iron overload disrupted liver morphology, induced reactive oxygen species (ROS) production, reduced superoxide dismutase (SOD) activity, caused lipid peroxidation, and led to DNA fragmentation. Iron overload altered the overall composition of lipid ions in the liver, with significant changes in over 100 unique lipid ions. Notably, iron overload selectively increased the overall abundance of glycerolipids and changed the composition of glycerophospholipids and sphingolipids. This study, one of the first to report iron-overload induced lipid alterations on a global lipidomics scale, provides early insight into lipid ions that may be involved in iron overload-induced pathology.

scholarly journals Profile of hepatocellular carcinoma in the Republic of Moldova: first-hand information on the presentation, distribution and etiologies

2019 ◽  
Vol 57 (1) ◽  
pp. 37-46
Author(s):  
Adela Turcanu ◽  
Ecaterina Pitel ◽  
Vlada-Tatiana Dumbrava ◽  
Eugen Tcaciuc ◽  
Ana Donscaia ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Tumors ◽  
Hepatitis Virus ◽  
Primary Liver Cancer ◽  
Virus Surface ◽  
Primary Liver Tumors ◽  
B Virus ◽  
Tertiary Healthcare ◽  
Serum Alpha Fetoprotein ◽  
The Republic

Abstract Introduction. Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital. Methods. A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation. Results. The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases. Conclusions. The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.

scholarly journals Horizons of development of immunotherapy for malignant liver tumors

2021 ◽  
pp. 81-89
Author(s):  
V. E. Mukhin ◽  
Yu. S. Konstantinova ◽  
R. R. Gimadiev ◽  
N. V. Mazurchik
Keyword(s):  
Liver Tumors ◽  
Surgical Excision ◽  
Malignant Neoplasms ◽  
Therapeutic Approaches ◽  
Liver Malignancies ◽  
Primary Liver Tumors ◽  
Malignant Liver Tumors ◽  
Malignant Liver ◽  
Methods Of Treatment ◽  
New Strategies

Primary liver tumors are one of the most common types of malignant neoplasms. Surgical excision is still the most effective treatment in the early stages of the disease, however in most cases early diagnosis is difficult. Moreover, even if the treatment is carried out according to a radical program, the risk of relapse remains extremely high. In this regard, the search for new strategies for the treatment of liver malignancies that differ from traditional methods of treatment is not terminated. One of such promising approaches is immunotherapy. The present review is devoted to the current understanding of the mechanisms of action and the available clinical experience in the use of immunotherapy approaches in the treatment of liver malignancies. Combining different types of immunotherapy or combining immunotherapy with traditional therapeutic approaches can facilitate a synergistic effect and contribute to the development of personalized medicine.

Sign in / Sign up

Export Citation Format

Share Document