Choice of approach for hepatectomy for hepatocellular carcinoma located in the caudate lobe: Isolated or combined lobectomy?

Liu, Peng; Qiu, Bao‐An; Bai, Gang; Bai, Hongwei; Xia, Nian-Xin; Yang, Ying-Xiang; Zhu, Jian-Yong; An, Yang; Hu, Bing

doi:10.3748/wjg.v18.i29.3904

Cited by 17 publications

(33 citation statements)

References 28 publications

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“…Isolated caudate lobectomy offers the possibility of radical resection and allows the surgeon to preserve the functional hepatic parenchyma 3 . There are four main surgical approaches for open caudate lobectomy: left-sided, right-sided, combined left- and right-sided, and anterior transhepatic 4 . A fifth approach, the retrograde approach, was recently proposed for tumors invading the IVC 5 .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic isolated caudate lobe resection

Parikh¹,

Han

Cho

et al. 2021

Sci Rep

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Previously, isolated caudate lobectomy was rarely performed and the caudate lobe was usually resected along with other segments. Isolated caudate lobe resection is a challenging procedure even for an experienced surgeon. Our aim was to evaluate the feasibility, safety and outcomes of laparoscopic isolated caudate lobectomy and to compare these with the open technique. We retrospectively analyzed 21 patients who underwent isolated caudate lobectomy between January 2005 and December 2018 at Seoul National University Bundang Hospital. Patients who underwent either anatomical or non-anatomical resection of the caudate lobe were included. Patients were divided into two groups according to whether they underwent laparoscopic or open surgery. Intra-operative and postoperative outcomes were compared with a median follow-up of 43 months (4–149). A total of 21 patients were included in the study. Of these, 12 (57.14%) underwent laparoscopic and nine (42.85%) underwent open caudate lobectomy. Median operation time (204.5 vs. 200 minutes, p = 0.397), estimated blood loss (250 vs. 400 ml, p = 0.214) and hospital stay (4 vs. 7 days, p = 0.298) were comparable between laparoscopy and open group. The overall post operative complication rate was similar in both groups (p = 0.375). The 5-year disease free survival rate (42.9% vs 60.0%, p = 0.700) and the 5-year overall survival rate (76.2% vs 64.8%, p = 0.145) was similar between laparoscopy and open group. Our findings demonstrate that with increasing surgical expertise and technological advances, laparoscopic isolated caudate lobectomy can become a feasible and safe in selected patients.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic isolated caudate lobe resection

Parikh¹,

Han

Cho

et al. 2021

Sci Rep

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“…HCC located at the caudate lobe with encircling involvement of the retrohepatic IVC has often been treated with HR through various surgical approach methods. 3 4 5 6 The transhepatic approach, dividing the hepatic parenchyma to expose the paracaval portion, is a feasible method used to reduce the risk of tumor handling-associated tumor spread. Downstaging with preoperative TACE had been attempted, but its therapeutic effect was worse than expected.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatic resection (HR) is considered to be the preferred treatment method for HCC but is also considered to be a challenging surgical procedure in the presence of liver cirrhosis. HR resection for HCC encircling the retrohepatic inferior vena cava (IVC) increases the risk of an intraoperative tumor spread during the handling of the hypervascular mass 3456…”

Section: Introductionmentioning

confidence: 99%

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Long-term complete response after transcatheter arterial chemoembolization and stereotactic body radiation therapy in a patient with hepatocellular carcinoma at the caudate lobe

Chung

Hwang

et al. 2018

Ann Hepatobiliary Pancreat Surg

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It is expected that a combination of transcatheter arterial chemoembolization (TACE) with stereotactic body radiation therapy (SBRT) may induce synergistic therapeutic effects in hepatocellular carcinoma (HCC), which would result in a high rate of complete therapeutic response. In this study, we present the 5-year clinical course of a patient who had HCC at the caudate lobe, which was treated with TACE and SBRT. A 53-year-old male was diagnosed with an 8 cm-sized HCC at the caudate lobe with compression of the inferior vena cava (IVC). For fear of pulmonary metastasis, we decided to perform sequential TACE-radiotherapy instead of upfront hepatectomy, although the tumor appeared resectable. The first session of TACE, SBRT with 12 fractions, and the second session of TACE were sequentially performed. The patient was administered metformin for chemoprevention. Over the course of a 5-year follow-up, there was no evidence of HCC recurrence. We reported the clinical sequence of a patient showing complete therapeutic response of HCC at the caudate lobe after a combination of TACE and radiotherapy. This type of combined locoregional treatment can be a therapeutic option for HCC at the caudate lobe with marginal resectability.

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“…The caudate lobe lied posterior to the confluence of the left and middle hepatic veins as they entered the IVC. Any injury to these vital vessels will lead to massive bleeding (10,11).…”

Section: Discussionmentioning

confidence: 99%

Technical notes on pure laparoscopic isolated caudate lobectomy for patient with liver cancer

Cheung

2016

Transl. Gastroenterol. Hepatol.

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Choice of approach for hepatectomy for hepatocellular carcinoma located in the caudate lobe: Isolated or combined lobectomy?

Abstract: The caudate lobectomy combined with an additional partial hepatectomy is preferred because this approach is technically less demanding and offers an adequate surgical margin.

Cited by 17 publications

References 28 publications

Laparoscopic isolated caudate lobe resection

Laparoscopic isolated caudate lobe resection

Long-term complete response after transcatheter arterial chemoembolization and stereotactic body radiation therapy in a patient with hepatocellular carcinoma at the caudate lobe

Technical notes on pure laparoscopic isolated caudate lobectomy for patient with liver cancer

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