Significance of Hepatic Resection Combined with Inferior Vena Cava Resection and Its Reconstruction with Expanded Polytetrafluoroethylene for Treatment of Liver Tumors

Arii, Shigeki; Teramoto, Kennichi; Kawamura, T.; Takamatsu, Susumu; Sato, Eigo; Nakamura, Noriaki; Iwai, Takahisa; Mori, Akira; Tanaka, Junji; Imamura, Masayaki

doi:10.1016/s1072-7515(02)01616-2

Cited by 74 publications

(73 citation statements)

References 13 publications

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“…Around 2010, several authors reported that liver resections combined with a simultaneous diaphragm excision resulted in high morbidity (44%) but relative low mortality (3-7%) compared to a liver resection alone for advanced colorectal liver metastases (8,9). In contrast, conscerning about hepatectomy combined with a IVC resection, several studies reported high morbidity and mortality (40-43 and 8-11% respectively) (11,18,19). Those findings suggested that a hepatectomy combined with a diaphragm resection required additional attention to postoperative complications, but it could be safely conducted currently.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcome of extended liver resections for colorectal liver metastasis compared with standard liver resections

et al. 2018

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Abstract. Colorectal liver metastatic lesions sometimes invade adjacent organs. A hepatectomy is often extended to include the involved adjacent organ to achieve negative surgical margins. The purpose of the present retrospective study was to evaluate the surgical outcomes of extended liver resections and patients' prognoses. The medical records of 178 patients with colorectal liver metastasis who underwent liver resections in the Department of Gastroenterological Surgery at Osaka University Hospital (Suita, Japan), from 2000 to 2015 were reviewed. These patients were divided into two groups: the extended resection group (n=20) and the non-extended resection group (n=158). The disease-free and overall survival curves were estimated with the Kaplan-Meier method and analyzed with the log rank test. It was observed that the extended resection group had longer operation times and increased blood loss, however perioperative morbidity was similar. The organs resected most frequently were the diaphragm (n=10) and inferior vena cava (n=5). Overall survival rates in the extended resection group were lower compared with the non-extended resection group (5-year survival rates; 45.0 vs. 67.9%), however the difference was not significant. It was indicated that the aggressive hepatectomy combined with resection of adjacent organs was an acceptable treatment with low perioperative morbidity. The overall survival rate may not be inferior to that of simple hepatectomy.

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Section: Discussionmentioning

confidence: 99%

Surgical outcome of extended liver resections for colorectal liver metastasis compared with standard liver resections

et al. 2018

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“…In addition, another crucial problem is how to reduce recurrence after surgery. In order to extent the surgical indications, portal vein embolization [1,2] and combined vascular resection [3] have been performed. With respect to reducing intrahepatic recurrence from a surgical viewpoint, anatomical resection along the portal tributary has been proposed [4] because HCC cells usually spread through the portal vein, and intrahepatic metastasis is frequently observed in the same portal area as the main tumor.…”

Section: Introductionmentioning

confidence: 99%

Surgical Strategies for Hepatocellular Carcinoma with Special Reference to Anatomical Hepatic Resection and Intraoperative Contrast-Enhanced Ultrasonography

Arii

Tanaka²,

Mitsunori³

et al. 2010

Oncology

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Here we described our strategies to attain a better prognosis for hepatocellular carcinoma (HCC) patients by surgery. Among a variety of attempts conducted to date, we focused on anatomical resection and intraoperative contrast-enhanced ultrasonography. There are still controversies with respect to the significance of anatomical resection. We analyzed the significance of this surgical procedure in 207 patients without macrovascular invasion. These patients underwent either anatomical resection or non-anatomical resection. We found that the patients with anatomical resection had higher recurrence-free survival rate than those with non-anatomical resection. Univariable analysis showed that liver damage, the serum level of α-fetoprotein, tumor number, surgical margin, and type of surgery (anatomical or non-anatomical resection) were significant predictive factors for intrahepatic recurrence. Multivariable analysis revealed that multiple tumors, α-fetoprotein, and non-anatomical resection were independent risk factors for recurrence. We conclude that anatomical resection is a recommendable surgical procedure in patients without macrovascular invasion. A recent innovation is the development of contrast-enhanced ultrasonography. Then we have applied this to liver surgery intraoperatively. We confirm that vascular images contribute to a precise diagnosis and the detection of small portal tumor thrombi, and that Kupffer images are useful to discover the minute tumors. In addition, by clarifying the relationship between tumors and the vascular architecture, real-time 3-dimensional images using Kupffer imaging are a promising guide during the surgical procedures, although further development is needed.

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“…Therefore, removal of the entire liver, combined with retrohepatic IVC, was needed to minimize mobilization and maximize oncologic safety. The IVC resection and reconstruction, combined with liver transplant for hepatic malignancy or extensive retroperitoneal tumor involving the IVC [3][4][5][6] or for a patient in an urgent state, [7][8][9] have been performed in select cases. In these cases, an autologous iliac vein, a deceased-donor vena cava or a prosthetic graft (including Dacron and polytetrafluoroethylene) have been used for reconstruction of the IVC.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, long-term results regarding graft patency and graft-related complications are acceptable. Although there is a lack of long-term results for graft patency, several case reports have shown good patency during 1-to 11-year follow-up, 3,6,7,9,11 and one of the largest case series 2 shows favorable results of late prosthetic caval graft patency (> 90%) at a median follow-up of 3 years with long-term anticoagulation therapy. In the case of an anastomotic stenosis, this can be safely managed with radiologic intervention.…”

Section: Discussionmentioning

confidence: 99%

Living-Donor Liver Transplant With an Interposition Graft of the Inferior Vena Cava for Hepatocellular Carcinoma: Beyond the Milan Criteria and Within the UCSF Criteria

Ahn

Kang²,

Kim³

et al. 2013

Exp Clin Transplant

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Living-donor liver transplant for a big hepatocellular carcinoma located in the caudate lobe is challenging owing to dissemination of cancer cells during recipient hepatectomy. We report a case of living-donor liver transplant using the right side of the liver of a living donor combined with inferior vena cava interposition graft after en bloc resection of the liver and retrohepatic inferior vena cava for hepatocellular carcinoma in the caudate lobe. A 50-year-old man with chronic hepatitis B cirrhosis developed hepatocellular carcinoma in the caudate lobe and segment 5. The diameters of the masses were 4.5 cm and 2.5 cm. His model for end-stage liver disease score was 17, and he had a moderate amount of ascites. For the recipient hepatectomy, en bloc resection of the entire liver, including retrohepatic inferior vena cava and reconstruction of inferior vena cava with Dacron graft, were performed. We then performed a transplant of the right lobe taken from the living donor. This technique can be a new alternative curative treatment option for hepatocellular carcinoma located on the hepatocaval confluence or close to the inferior vena cava. We should evaluate the long-term safety for cancer recurrence and infection of an artificial vascular graft in the milieu of immunosuppression after liver transplant.

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Significance of Hepatic Resection Combined with Inferior Vena Cava Resection and Its Reconstruction with Expanded Polytetrafluoroethylene for Treatment of Liver Tumors

Cited by 74 publications

References 13 publications

Surgical outcome of extended liver resections for colorectal liver metastasis compared with standard liver resections

Surgical outcome of extended liver resections for colorectal liver metastasis compared with standard liver resections

Surgical Strategies for Hepatocellular Carcinoma with Special Reference to Anatomical Hepatic Resection and Intraoperative Contrast-Enhanced Ultrasonography

Living-Donor Liver Transplant With an Interposition Graft of the Inferior Vena Cava for Hepatocellular Carcinoma: Beyond the Milan Criteria and Within the UCSF Criteria

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