Outcome quality standards for surgery of colorectal liver metastasis

Oliver, Manuel Bellver; Escrig-Sos, Javier; Rotellar, Fernando; Moya-Herráiz, Ángel; Sabater-Ortí, Luis

doi:10.1007/s00423-020-01908-w

Cited by 8 publications

(2 citation statements)

References 77 publications

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“…Demographic, clinical, intraoperative, postoperative, and histopathological variables were included according to previous recommendations in the literature ( 25 ).…”

Section: Methodsmentioning

confidence: 99%

Prevention of post-hepatectomy liver failure after major resection of colorectal liver metastases: is hepato-biliary scintigraphy the optimal tool?

Cusumano¹,

Deshayes²,

Guiu³

et al. 2023

Ann Transl Med

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Background Liver failure is the most threatening complication after hepatectomy for colorectal liver metastases. Recent studies indicate that liver functional evaluation by hepatobiliary scintigraphy (HBS) could be more sensitive than volumetry to predict the risk of post-hepatectomy liver failure (PHLF). The aim of this study was to evaluate the performance of 99m Tc-mebrofenin HBS, when used as the main preoperative assessment before major hepatectomy in patients with liver metastases from colorectal cancer. Methods This retrospective study reviewed data from all patients with colorectal liver metastases treated at Montpellier Cancer Institute between 2013 and 2020. Only patients who underwent HBS before surgery were included. The primary aim was to evaluate how the use of this functional imaging modifies the surgical management of patients with colorectal liver metastases. Results Among the 80 patients included, 26 (32.5%) underwent two-stage hepatectomy and 13 (16.3%) repeated hepatectomies. Severe postoperative complications occurred in 16 patients (20%) and all-grade liver failure occurred in 13 patients (16.3%). Seventeen patients (21.3%) underwent major liver surgery based on sufficient mebrofenin uptake, although the retrospectively evaluated future liver remnant (FLR) volume was insufficient (<30% of total liver). None of these patients had PHLF. Conclusions This study showed the reliability of HBS for the preoperative functional assessment of patients with colorectal liver metastases. Indeed, it allowed performing major hepatectomy safely in 20% more patients who would not have been considered for surgery on the basis of volumetric assessment.

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“…Demographic, clinical, intraoperative, postoperative, and histopathological variables were included according to previous recommendations in the literature ( 25 ).…”

Section: Methodsmentioning

confidence: 99%

Prevention of post-hepatectomy liver failure after major resection of colorectal liver metastases: is hepato-biliary scintigraphy the optimal tool?

Cusumano¹,

Deshayes²,

Guiu³

et al. 2023

Ann Transl Med

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“…The definition of PHH depends on the value of postoperative serum hemoglobin in any postoperative transfusion of packed red blood cells (PRBC) or on the evidence of intraabdominal bleeding obtained by imaging and/or blood loss via abdominal drains. According to the literature, PHH is a quite rare event and in dedicated centers, its standard rate is below 3% [ 107 ].…”

Section: Postoperative Complicationsmentioning

confidence: 99%

Perioperative Management of Complex Hepatectomy for Colorectal Liver Metastases: The Alliance between the Surgeon and the Anesthetist

Giustiniano

Nisi

Rocchi

et al. 2021

Cancers

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Hepatic resection has been widely accepted as the first choice for the treatment of colorectal metastases. Liver surgery has been recognized as a major abdominal procedure; it exposes patients to a high risk of perioperative adverse events. Decision sharing and the multimodal approach to the patients’ management are the two key items for a safe outcome, even in such a high-risk surgery. This review aims at addressing the main perioperative issues (preoperative evaluation; general anesthesia and intraoperative fluid management and hemodynamic monitoring; intraoperative metabolism; administration policy for blood-derivative products; postoperative pain control; postoperative complications), in particular, from the anesthetist’s point of view; however, only an alliance with the surgery team may be successful in case of adverse events to accomplish a good final outcome.

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Influence of the tumor site and histopathology after resection for non-colorectal non-neuroendocrine liver metastases. A single center experience

De-Armas-Conde

Ramon-Rodriguez²,

Prada-Villaverde³

et al. 2023

Cirugía Española (English Edition)

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Outcome quality standards for surgery of colorectal liver metastasis

Cited by 8 publications

References 77 publications

Prevention of post-hepatectomy liver failure after major resection of colorectal liver metastases: is hepato-biliary scintigraphy the optimal tool?

Prevention of post-hepatectomy liver failure after major resection of colorectal liver metastases: is hepato-biliary scintigraphy the optimal tool?

Perioperative Management of Complex Hepatectomy for Colorectal Liver Metastases: The Alliance between the Surgeon and the Anesthetist

Influence of the tumor site and histopathology after resection for non-colorectal non-neuroendocrine liver metastases. A single center experience

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