Ante situm liver resection with inferior vena cava replacement under hypothermic cardiopolmunary bypass for hepatoblastoma: Report of a case and review of the literature

Angelico, Roberta; Passariello, Annalisa; Pilato, Michele; Cozzolino, Tommaso; Piazza, Marcello; Miraglia, Roberto; D’Angelo, Paolo; Capasso, Mariella; Saffioti, Maria Cristina; Alberti, Daniele; Spada, Marco

doi:10.1016/j.ijscr.2017.06.008

Cited by 17 publications

(14 citation statements)

References 15 publications

(23 reference statements)

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“…Vascular reconstruction with extracorporeal circulation is a challenging surgical technique in hepatic resection or LT for HB with tumor thrombi extending into the IVC and RA. To the best of our knowledge, 16 cases of extracorporeal circulation for cases of HB with IVC thrombi or RA (including the present case) have been reported, as shown in Table 1 6,9,12,22‐26 . Hepatic resection was performed under cardiopulmonary bypass with hypothermic perfusion.…”

Section: Discussionmentioning

confidence: 99%

The extracorporeal circulation with transdiaphragmatic approach in living‐donor liver transplantation for HB with atrial extension of tumor thrombus: A case report

Shimizu

Sakamoto

Fukuda

et al. 2020

Pediatric Transplantation

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Surgical intervention for HB with tumor thrombi extending into the IVC and the RA might requires careful planning of the surgical procedures, including vascular reconstruction and extracorporeal circulation. We herein report a successful case of LDLT for HB with atrial extension of a tumor thrombus by extracorporeal circulation with a transdiaphragmatic approach. The patient was a 5‐year‐old boy with PRETEXT IV HB with a tumor thrombus that extended into the IVC and the RA. After 4 cycles of chemotherapy and resection of bilateral lung metastases, the size of the primary HB tumor decreased. As the tumor extension from the LHV to the RA had decreased but was still present, we performed LDLT with tumor thrombectomy. The central part of the diaphragm was sagittally incised to expose the suprahepatic IVC and the RA. Venovenous bypass was achieved from the right femoral vein and IMV to the RA En bloc resection of the native liver with the tumor thrombus was then performed. HV anastomosis was made between the newly created orifice on the IVC and the graft LHV. The duration of LDLT was 10 hours and 44 minutes (extracorporeal circulation time: 78 minutes). Pediatric LT for HB with the extension of tumor thrombi into the RA under extracorporeal circulation is a feasible option and allows for the expansion of the indications for transplantation for children with unresectable liver tumors.

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Section: Discussionmentioning

confidence: 99%

The extracorporeal circulation with transdiaphragmatic approach in living‐donor liver transplantation for HB with atrial extension of tumor thrombus: A case report

Shimizu

Sakamoto

Fukuda

et al. 2020

Pediatric Transplantation

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“…Papamichail et al described IVC reconstruction using cadaveric IVC graft without post-operative vascular complications [18]. For other hepatic tumours invading the IVC, aortic grafts from deceased donors were also adopted, with the possible advantage of reducing the risk of vessel collapse due to its thickness [40]. Moreover, cadaveric grafts have the possible advantage of not requiring long-term anticoagulation therapy [41].…”

Section: Figurementioning

confidence: 99%

“…The ante situm operation was first described in 1991 by Hannoun [52] (Figure 3B-D). This technique entails complete mobilisation of the liver and vena cava, TVE and HP through the PV, followed by sections of the hepatic veins or the vena cava itself [40]. This allows complete rotation of the liver (ex situ), giving full access to the posterior liver, cava and hepatocaval confluence, while preserving the hepatic pedicle (in vivo) and reducing the risk of vascular complication into the hilum vessels, especially to the hepatic artery.…”

Section: Figurementioning

confidence: 99%

Vascular Involvements in Cholangiocarcinoma: Tips and Tricks

Angelico

Sensi

Parente

et al. 2021

Cancers

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Cholangiocarcinoma (CCA) is an aggressive malignancy of the biliary tract. To date, surgical treatment remains the only hope for definitive cure of CCA patients. Involvement of major vascular structures was traditionally considered a contraindication for resection. Nowadays, selected cases of CCA with vascular involvement can be successfully approached. Intrahepatic CCA often involves the major hepatic veins or the inferior vena cava and might necessitate complete vascular exclusion, in situ hypothermic perfusion, ex situ surgery and reconstruction with autologous, heterologous or synthetic grafts. Hilar CCA more frequently involves the portal vein and hepatic artery. Resection and reconstruction of the portal vein is now considered a relatively safe and beneficial technique, and it is accepted as a standard option either with direct anastomosis or jump grafts. However, hepatic artery resection remains controversial; despite accumulating positive reports, the procedure remains technically challenging with increased rates of morbidity. When arterial reconstruction is not possible, arterio-portal shunting may offer salvage, while sometimes an efficient collateral system could bypass the need for arterial reconstructions. Keys to achieve success are represented by accurate selection of patients in high-volume referral centres, adequate technical skills and eclectic knowledge of the various possibilities for vascular reconstruction.

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“…Qiu et al indicated type IV end-stage HAE patients with the opportunity to be operated in vivo based on "IHP" vascular infiltrated degree classification (36). For some cases, ante-situm liver resection with inferior vena cava (IVC) replacement procedure replaced ERAT procedure for radical resection for some special location (28,37). And, the continuous pringle maneuver and in situ hypothermic perfusion through the inferior mesenteric vein (IMV) may resect the lesion in vivo, rather than removing the entire liver for lesion resection in vitro (38).…”

Section: Candidatementioning

confidence: 99%

Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis

Yang

Deng

et al. 2020

Ann Palliat Med

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Hepatic alveolar echinococcosis (HAE) is a cosmopolitan zoonosis distribute widely in the northern hemisphere with high estimated 10-year mortality. Radical resection combined with oral albendazole administration are the major methods for HAE treatment, whereas most patients delayed diagnosis and treatment because which was considered as benign disease. For the cases with end-stage HAE could not be treated through conventional hepatectomy, allograft liver transplantation (LT) was regarded as a life-saving technique previously. However, graft shortage, high recurrence rate and long-term immunosuppressive therapy limited its utilization. Since the ex-vivo liver resection and autotransplantation (ERAT) procedure was first used in treating for end-stage HAE in 2011, there are more than 120 HAE cases patients were reported treating in this method up to now. Comparing with LT, ERAT needs neither an organ donor nor long term immunosuppressive therapy, and provide preferable overall survival rates. Based on the conventional ERAT procedure, some modification such as auxiliary partial autologous LT were introduced in the high selected end-stage HAE patients presently. However, the standard procedures for ERAT including surgical details and perioperative management have not been established because of limited reported cases. Also, the present ERAT experience for end-stage HAE treatment are all summarizes by the Chinese surgeon groups. For summarizing the knowledge and experience details, we reviewed present opinions about ERAT for end-stage HAE patients, and presented the future perspectives about this topic in this manuscript. We aimed at discussing the feasibility, indications, preparation, technical details, and postoperative outcomes of ERAT for HAE patients.

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Ante situm liver resection with inferior vena cava replacement under hypothermic cardiopolmunary bypass for hepatoblastoma: Report of a case and review of the literature

Cited by 17 publications

References 15 publications

The extracorporeal circulation with transdiaphragmatic approach in living‐donor liver transplantation for HB with atrial extension of tumor thrombus: A case report

The extracorporeal circulation with transdiaphragmatic approach in living‐donor liver transplantation for HB with atrial extension of tumor thrombus: A case report

Vascular Involvements in Cholangiocarcinoma: Tips and Tricks

Current status of ex-vivo liver resection and autologous liver transplantation for end-stage hepatic alveolar echinococcosis

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