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We compared histologic findings in nonneoplastic portions of liver resected during surgery associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) with those from hepatectomy after portal vein embolization (PVE).Effects of congestion and ischemia in ALPPS on hepatocyte regeneration are incompletely understood, as are those on hepatocyte maturity.Specimens obtained from...
Tumor reduction by present-day prehepatectomy chemotherapy can render initially unresectable disease resectable. However, little is known about whether effects on liver metastases with radiologically defined “attachment to or invasion of” major intrahepatic vessels differ between chemotherapy regimens with or without monoclonal antibodies. We compared histologically the relationships between liver...
Although short- and long-term results have been described in previous reports of 2-stage hepatectomy, growth activity in metastases resected at the first versus second hepatectomy has not been compared.We analyzed growth activity of liver metastases from colorectal cancers resected at first and second hepatectomy by real-time reverse-transcription polymerase chain reaction and immunohistochemistry...
Although the consequences of partial venous outflow interruption have attracted only limited attention in liver surgery, maximal preservation of liver function after hepatic resection requires preservation of circulation in the remnant liver, especially hepatic vein drainage.Data from 30 patients undergoing 3-dimensional imaging were analyzed to clarify the relationship between the area of the ventral...
Although anatomic liver resection is preferred when treating hepatocellular carcinoma (HCC), evidence that it improves survival when compared with an adequate nonanatomic resection is lacking. The purpose of this study was to compare the survival impact of anatomic versus nonanatomic resection in patients with solitary HCC.Clinicopathologic data were available for 125 patients who underwent hepatectomy...
Although retrospective studies have demonstrated survival benefit from hepatectomy for metastatic colorectal cancer, few studies have examined patients with multiple bilobar metastases to identify survival-related factors throughout their course.Among 277 patients with R0 resection for liver metastases from colorectal cancer, 79 patients had 4 or more lesions in a bilobar distribution. To determine...
Complex, highly variable, anatomic relationships in the portal hilum complicate the surgical management at hilar cholangiocarcinoma. Preoperative three-dimensional (3D) imaging to stage the tumor and define anatomy may help in planning for curative resection.Between 2003 and 2006, 20 consecutive patients with hilar cholangiocarcinoma underwent preoperative multidetector row computed tomography (MDCT)...
We investigated perioperative complications of hepatic arterial infusion chemotherapy preceding major hepatectomy for multiple bilobar colorectal cancer metastases. No consensus exists concerning operative feasibility or perioperative course in patients undergoing major liver resection with neoadjuvant chemotherapy—partly because such chemotherapy is considered hepatotoxic, increasing the risk of...
We investigated the efficacy of microwave ablation plus hepatectomy for multiple bilobar colorectal metastases to the liver. No consensus exists concerning local ablation plus hepatic resection for treating multiple bilobar colorectal liver metastases, partly because of a lack of long-term comparative survival data.Clinicopathologic data were analyzed retrospectively for 53 consecutive patients with...
Consensus remains to be achieved concerning prehepatectomy neoadjuvant chemotherapy as a treatment strategy for multiple bilobar colorectal liver metastases, in part because the effect of prehepatectomy neoadjuvant chemotherapy has not been determined pathologically. We investigated the efficacy of prehepatectomy intra-arterial chemotherapy for multiple bilobar colorectal cancer metastases to the...
Background: Precise subtotal hepatectomies based on the vascular anatomy revealed by preoperative three-dimensional computed tomography (3D-CT) were reviewed to examine the usefulness of 3D-CT. Methods: The clinical records and 3D-CT images of 20 patients with 24 hepatomas less than 50 mm in diameter who underwent hepatectomy for hepatocellular carcinoma and metastatic tumors and the usefulness of...
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