The extension of surgical resection of metastatic liver cancer

By | October 19, 2011

Metastatic liver cancer surgery: For the large volume of technically may be removed, but may be liver failure after hepatic resection of colorectal cancer liver metastases can be the same side of the liver resection first selective portal vein embolization (portal vein embolization, PVE). Ipsilateral liver atrophy after PVE to pay the side of the healthy liver hyperplasia, which can avoid the occurrence of liver failure, increased metastasis of two surgical resection. If the preoperative PVE and TACE in combination, can reduce the tumor burden is to reduce the transfer operation opportunities in the portal vein tumor thrombus, but also over the liver by induction of miles in the future, help to improve surgical resection of liver metastases of multiple possible and safety, in particular, has a huge pay a few isolated / limited metastatic liver cancer patients with obvious effect. Clinical use of the right portal vein embolization more, the left portal vein embolization can also meet the extended left hepatectomy.
Surgical resection of metastatic liver cancer: the implementation of ultrasound-guided percutaneous PVE, portal vein from the contralateral branch of the liver biopsy, for the prevention of embolic reflux effect of portal vein thrombosis, can be blocked with a balloon catheter lumen after portal vein injection of chemotherapy drugs shy oil emulsion. After PVE has aminotransferase, bilirubin a transient increase, very few deaths reported. PVE can make the residual liver after liver resection liver volume accounted for less than 25% of patients successfully tolerated extended hepatectomy. PVE after the implementation of the long-term survival of liver resection and liver resection without PVE line (1,3,5 year survival rates were 81%, 67%, 40% and 88%, 61%, 38%). PVE within 24 hours after the contralateral liver regeneration is activated, 12-14 hours to reach peak. Therefore, the extension of liver resection should be -1 in 3 weeks after PVE months after the implementation of the preoperative patients without cirrhosis of liver volume of PEV can contralateral compensatory hypertrophy of 40% -60%, there is hyperplasia of the liver cirrhosis take a long time and poor results.
Surgical resection of metastatic liver cancer: clinical hepatic artery embolization does not appear similar effect PVE. HAl also reported in the literature can be reduced tumor burden, some patients can get delayed operation opportunities. Fang is such that the major "resectable" understanding of the concept of the deviation caused. In fact, for the operation of experienced surgeons and surgical centers, many of the "unresectable" patients are "resectable" the.

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