Anatomic segmental resection compared to major hepatectomy in the treatment of liver neoplasms

Helling, Thomas S.; Blondeau, Benoit

doi:10.1080/13651820510028828

Cited by 18 publications

(7 citation statements)

References 13 publications

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“…In general, for tumors located in the left lateral segment, a left lateral segmentectomy is relatively easier to perform than a single segment resection. 28 As a result, positive staining was not considered helpful as shown in Case 1 which included an HCC in segment S3. However, in cases in which a patient has an impaired liver function and can only tolerate a wedge resection, positive staining may be helpful in visualizing the resection line.…”

Section: Discussionmentioning

confidence: 95%

Super-Selective Intra-Arterial Indocyanine Green Administration for Near-Infrared Fluorescence-Based Positive Staining of Hepatic Segmentation: A Feasibility Study

Liu

et al. 2021

Surg Innov

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Background. Despite the increasing number of laparoscopic hepatic procedures for the resection of hepatocellular carcinoma (HCC), intraoperative tumor localization and demarcation remains challenging in comparison to open surgery. In this study, we evaluated the feasibility of positive liver segment staining through the super-selective intra-arterial indocyanine green (ICG) administration. Methods. Eight patients presenting with a single HCC underwent an interventional vascular procedure followed by laparoscopic surgery. A microcatheter was advanced into the hepatic artery branches perfusing the HCC followed by digital subtraction angiography and angiography computed tomography (angio-CT). Patients were then transferred to the operating room, and a laparoscopic hepatectomy was performed under ultrasound guidance. A 5 mL bolus of ICG with a concentration of .125 mg/mL was injected through the microcatheter, and a near-infrared laparoscope was used to detect the fluorescence signal to assess the correspondence between the fluorescence-based demarcation and the intraoperative ultrasound–based demarcation. Results. The duration for the angiography procedure was 32.7 +/− 5.3 min, and it took 242 +/− 118 min from the end of angiography procedure until the start of the surgical procedure. In all cases, the fluorescent liver segment was corresponding to the angio-CT findings. In 6/8 cases, fluorescence imaging was considered helpful in the identification of the resection line. In 3 patients, the resection line was changed according to the positively stained liver segment. Conclusion. We successfully demonstrated the feasibility of the super-selective intra-arterial ICG administration for fluorescence-based positive staining of hepatic segmentation during laparoscopic surgery for HCC (NCT04266548).

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Section: Discussionmentioning

confidence: 95%

Super-Selective Intra-Arterial Indocyanine Green Administration for Near-Infrared Fluorescence-Based Positive Staining of Hepatic Segmentation: A Feasibility Study

Liu

et al. 2021

Surg Innov

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“…One study by Zorzi et al showed that wedge resections were comparable to anatomic resections with respect to positive surgical margins, recurrence, median survival and 5-year survival [21]. Helling et al demonstrated that if feasible, segmental resections were preferred over major anatomic resections because there were less postoperative complications and overall survival was comparable [22].…”

Section: Discussionmentioning

confidence: 98%

The current role of intraoperative ultrasound during the resection of colorectal liver metastases: A retrospective cohort study

Knowles

Bertens

Croome

et al. 2015

International Journal of Surgery

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“…Segmental liver resection is preferable because it can conserve liver function and reduce postoperative complications in the treatment of liver neoplasms ( 2 , 3 ). In cases of segmental surgery, the greater the posterior liver is, the more difficult the surgery can be ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

In Vivo Evaluation of Feeding Arteries of Tumors in Dorsal Sector of the Liver

Chen

Wei

et al. 2015

Iran J Radiol

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Background:The identification of the dorsal sector of the liver and its detailed vascular anatomy is of primary importance for surgical practice and segmental transcatheter arterial chemoembolization.Objectives:This study aimed to investigate the feeding arteries of tumors in dorsal sector of the liver.Patients and Methods:Computed tomography (CT) and digital subtraction angiography (DSA) images of eleven patients with tumors of the dorsal sector of the liver were analyzed retrospectively. The hepatic arteries that probably supplied the tumors were observed in DSA images. The case number of each hepatic artery feeding to the tumors was calculated. A scoring method was used to estimate each hepatic artery contribution to the tumor stain in DSA images. The accumulative scores were employed to evaluate the blood supply of feeding arteries of the tumors.Results:The data of the study revealed that right posterior hepatic artery (RPHA) (n = 9), middle hepatic artery (MHA) (n = 8), left medial hepatic artery (LMHA) (n = 6), right anterior hepatic artery (RAHA) (n = 5), and caudate hepatic artery (CaHA) (n = 3) were the feeding arteries of the tumors in dorsal sector in eleven patients. The accumulative scores of RPHA, MHA, RAHA, and LMHA were 23, 17, 11, and 7 points, respectively (χ2 = 6.827, P = 0.078, Friedman test). The total scores of right hepatic artery (RHA) branches and left hepatic artery (LHA) branches were 51 and 11 points, respectively (Z = -2.764, P = 0.006, Wilcoxon rank test).Conclusion:The RPHA, MHA, RAHA, and LMHA might be the main feeding arteries of the tumors in dorsal sector of the liver.

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Anatomic segmental resection compared to major hepatectomy in the treatment of liver neoplasms

Cited by 18 publications

References 13 publications

Super-Selective Intra-Arterial Indocyanine Green Administration for Near-Infrared Fluorescence-Based Positive Staining of Hepatic Segmentation: A Feasibility Study

Super-Selective Intra-Arterial Indocyanine Green Administration for Near-Infrared Fluorescence-Based Positive Staining of Hepatic Segmentation: A Feasibility Study

The current role of intraoperative ultrasound during the resection of colorectal liver metastases: A retrospective cohort study

In Vivo Evaluation of Feeding Arteries of Tumors in Dorsal Sector of the Liver

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