Khirurgiia · 2002
[Central segments resections in primary liver neoplasms--three clinical cases].
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Tasev V, Bulanov D, Gaŭdarski R
Аннотация
BACKGROUND/AIMS: The resections of the central paramedial hepatic sectors are most rarely reported due to their technical complexity. We present three cases in which we carried out this rare operative intervention for occasion of primary hepatic neoplasm in the central hepatic segments.
MATERIAL AND METHODS: In three cases (two of primary hepatic cancer and one of sarcoma) we carried out resection of the central segments in the following steps: mobilization of the liver, subhepatic approach to the inferior v. cava, preparation for vascular isolation of the liver by Pringle's maneuver, dissection of the biliary, arterial and venous vessels in the hepatic hilus, intraoperative assessment of the involvement of these structures in the neoplastic process and subsequent hepatic resection.
RESULTS: For a period of 5 to 24 months of follow up we have not established a relapse of the disease in the cases ascribed.
CONCLUSION: The outcome of the hepatic resections strongly depends from the various factors including accurate preoperative diagnosis, the assessment of the resection volume according to the involvement of the hepatic vessels in the neoplastic process. Hepatic resection can be performed with the same degree of confidence and similar low morbidity as any other major surgical procedure.
MATERIAL AND METHODS: In three cases (two of primary hepatic cancer and one of sarcoma) we carried out resection of the central segments in the following steps: mobilization of the liver, subhepatic approach to the inferior v. cava, preparation for vascular isolation of the liver by Pringle's maneuver, dissection of the biliary, arterial and venous vessels in the hepatic hilus, intraoperative assessment of the involvement of these structures in the neoplastic process and subsequent hepatic resection.
RESULTS: For a period of 5 to 24 months of follow up we have not established a relapse of the disease in the cases ascribed.
CONCLUSION: The outcome of the hepatic resections strongly depends from the various factors including accurate preoperative diagnosis, the assessment of the resection volume according to the involvement of the hepatic vessels in the neoplastic process. Hepatic resection can be performed with the same degree of confidence and similar low morbidity as any other major surgical procedure.