Laparoscopic Anatomical Resection of Liver Segment 8 via a Hepatic Parenchymal Transection-first Approach Guided by the Middle Hepatic Vein

Background Although recent technological developments and improved endoscopic procedures have further extended the application of laparoscopic liver resection, pure laparoscopic anatomic resection of liver segment 8 (S8) is still rarely performed due to the lack of an appropriate surgical approach. This article discusses the technical tips and operation methods for laparoscopic anatomical resection of liver S8 via a hepatic parenchymal transection-first approach.Methods Clinical data of 14 patients who underwent laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein (MHV) in the Second Affiliated Hospital, Third Military Medical University (Army Medical University) from May 2017 to December 2019 were retrospectively analyzed. The operation time, intraoperative blood loss, postoperative complications, and hospitalization duration were observed.Results The operation was successful with no complications. No other abnormality was noted during outpatient follow-up examination.Conclusions Laparoscopic anatomical resection of liver S8 is still quite challenging at present, and it is our goal to design a reasonable procedure with accurate efficacy and high safety. We use hepatic parenchymal transection-first approach guided by the MHV for laparoscopic anatomical resection of liver S8. This technique overcomes the problem of high technical risk, greatly reduces the surgical difficulty and achieves technological breakthroughs, but there are still many problems worth further exploration.

Echinoderes xiphophorus sp. nov. – the first deep-water representative of Echinoderidae in the Sea of Japan (Kinorhyncha: Cyclorhagida)

A new species of echinoderid kinorhynchs, Echinoderes xiphophorus sp. nov. collected from oxidized brown silt at the deepest depression in the Sea of Japan, North-West Pacific, is described and illustrated using light and electron microscopy. This new representative of the most speciose kinorhynch genus is characterized by the unique set of spines and tubes and can easily be distinguished from most of its congeners. The second trunk segment bears three pairs of tubes in subdorsal, midlateral and ventrolateral position in both sexes; one pair of tubes on trunk segment 5 in lateroventral position and on trunk segment 8 in sublateral position; aciculate lateroventral spines on trunk segments 6–9; aciculate middorsal spines on trunk segments 4, 6, 8. This species is well recognized by very long tergal extensions of the posteriormost segment, some of the longest within the family Echinoderidae. Males of Echinoderes xiphophorus sp. nov. are well distinguished from all the congeners by extremely long sword-like appendages dorsally to three pairs of penile spines. The species constitutes the first deep-sea representative of the Echinoderidae in the Sea of Japan and the deepest representative of the Kinorhyncha in this sea.

Acute Intestinal Necrosis due to Diaphragmatic Hernia after Radiofrequency Ablation for Hepatocellular Carcinoma: A Case Report and Literature Review

Background: Radiofrequency ablation is widely used as an effective and minimally invasive treatment of hepatocellular carcinoma. The complications of radiofrequency ablation are mainly associated with needle damage or local thermal damage, while the reports of long-term complications of radiofrequency ablation are relatively rare.Case Report: This report presents a case of hepatocellular carcinoma with diaphragmatic hernia after radiofrequency ablation. A 60-year-old male came to the hospital with sudden abdominal pain for one day, who had received radiofrequency ablation and transcatheter arterial chemoembolization treatment for hepatocellular carcinoma located in segment 8 as an initial treatment 52 months ago. Computed tomography showed the right diaphragmatic hernia, small intestine intruding into the chest with intestinal obstruction. The patient underwent an emergency diaphragmatic repair with bowel resection and was successfully discharged 1 week after the operation.Conclusion: Diaphragmatic hernia is a long-term complication of radiofrequency ablation. Surgical treatment is recommended as the first choice when conditions permitted.