Combined liver and inferior vena cava resection for hepatic malignancy

Delis, Spiros; Madariaga, Juan; Ciancio, Gaetano

doi:10.1002/jso.20794

Cited by 29 publications

(33 citation statements)

References 14 publications

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“…In our recent series, the largest so far, we reported a five-year survival rate of 19.6 % for 21 patients with CRLM [4]. Other authors have described similar results, with five-year survival rates around 20 %, but the number of IVC resections for CRLM in these studies was small, ranging from 2 to 16 [10][11][12][13][14][15][16][17][18][19]. Despite these limitations, it seems reasonable to assume, on the basis of the available evidence, that liver surgery in this context prolongs survival and may achieve a cure.…”

Section: Discussionsupporting

confidence: 76%

Repeat hepatectomy with inferior vena cava re-resection for colorectal liver metastases: case report and review of the literature

et al. 2014

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Liver resection in patients with inferior vena cava (IVC) involvement is becoming more common with the adoption of vascular exclusion techniques and replacement of the IVC. Repeat hepatectomy and an aggressive surgical approach can offer satisfactory disease-free survival and a cure in selected patients. We herein describe a case of repeat hepatectomy with en bloc re-do IVC resection and reconstruction with Gore-Tex graft for recurrent colorectal liver disease. The patient had previously undergone non-anatomical right liver resection with IVC partial excision and reconstruction with a porcine pericardial patch. The patient is currently disease-free at 12 months' follow-up. Surgical treatment of liver tumors involving the IVC offers the only hope for prolonged survival. Re-do liver surgery with concomitant re-excision of the IVC is feasible and can be contemplated when macroscopic removal of the tumor is expected. Management of these complex cases by a specialist team with expertise in liver transplantation and vascular techniques is advised.

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Section: Discussionsupporting

confidence: 76%

Repeat hepatectomy with inferior vena cava re-resection for colorectal liver metastases: case report and review of the literature

et al. 2014

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“…Previously, a liver resection with a simultaneous diaphragm excision was associated with a greater incidence of perioperative morbidity and a significantly worse longterm outcome than liver resection alone (8,9). In addition, the only treatment modality for curing a primary or metastatic liver tumor that invaded IVC was an aggressive hepatectomy combined with resection and reconstruction of IVC, which is a challenging treatment with high morbidity and mortality rates (10,11).…”

Section: Introductionmentioning

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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“…The median (range) intraoperative blood loss, except in the patient who required CPB, was 500 (250-1500) mL (Table 1), and the median operative time was 320 (260-475min) min. The median tumour size was 11 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) cm (Fig. 3).…”

Section: Resultsmentioning

confidence: 99%

“…Vena cava reconstruction can be accomplished with PTFE graft as we previously published [18]. Autogenous vein grafts have been used due to their low thrombosis and infection rate; however, if long segments of the IVC require replacement this might not be technically feasible [19].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of large adrenal tumours: the University of Miami experience using liver transplantation techniques

et al. 2008

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OBJECTIVE To report our experience in the surgical management of patients with large adrenal masses and describe the key steps in performing radical resections, which are especially demanding where thrombi extend into the inferior vena cava (IVC). PATIENTS AND METHODS From 2003 to 2007, 14 patients presented with large adrenal mass, and underwent surgical extirpation. In five patients thrombi extended into the IVC, causing Budd–Chiari syndrome in one. RESULTS The median (range) patient age was 48 (40–58) years. The excision was radical with negative tumour margins in all cases. Cardiopulmonary bypass (CPB) was required in one case with adherent intra‐atrial thrombus. The mean blood loss was 500 (250–1500) mL except in the patient who required CPB. Morbidity included pleural effusion (three patients) and postoperative pneumonia (two), which responded to conservative management. All patients were alive and free of disease at a median follow‐up of 12 (5–42) months. CONCLUSIONS Surgical extirpation of large adrenal masses requires technical experience to optimize outcome. Total tumour excision is the only therapeutic option in such cases and provides acceptable results in survival and quality of life.

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Combined liver and inferior vena cava resection for hepatic malignancy

Abstract: Aggressive surgical management of liver tumors, offer the only hope for cure or palliation. We suggest that liver resection with vena cava replacement may be performed safely, with acceptable morbidity, by specialized surgical teams.

Cited by 29 publications

References 14 publications

Repeat hepatectomy with inferior vena cava re-resection for colorectal liver metastases: case report and review of the literature

Repeat hepatectomy with inferior vena cava re-resection for colorectal liver metastases: case report and review of the literature

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

Surgical management of large adrenal tumours: the University of Miami experience using liver transplantation techniques

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