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The Safety and Feasibility of Three-Dimensional Visualization Technology Assisted Right Posterior Lobe Allied with Part of V and VIII Sectionectomy for Right Hepatic Malignancy Therapy.
- Source :
-
Journal of laparoendoscopic & advanced surgical techniques. Part A [J Laparoendosc Adv Surg Tech A] 2018 May; Vol. 28 (5), pp. 586-594. Date of Electronic Publication: 2017 Nov 27. - Publication Year :
- 2018
-
Abstract
- Background: Hepatectomy is the optimal method for liver cancer; the virtual liver resection based on three-dimensional visualization technology (3-DVT) could provide better preoperative strategy for surgeon. We aim to introduce right posterior lobe allied with part of V and VIII sectionectomy assisted by 3-DVT as a promising treatment for massive or multiple right hepatic malignancies to retain maximum residual liver volume on the basis of R0 resection.<br />Methods: Among 126 consecutive patients who underwent hepatectomy, 9 (7%) underwent right posterior lobe allied with part of V and VIII sectionectomy. 21 (17%) underwent right hemihepatectomy (RH). The virtual RH was performed with 3-DVT, which provided better observation of spatial position relationship between tumor and vessels, and the more accurate estimation of the remnant liver volume. If remnant liver volume was <40%, right posterior lobe allied with part of V and VIII sectionectomy should be undergone. Then, the precut line ought to be planned on the basis of protecting the portal branch of subsegment 5 and 8. The postoperative outcome of patients was compared before and after propensity score matching.<br />Results: Nine patients meeting the eligibility criteria received right posterior lobe allied with part of V and VIII sectionectomy. The variables, including the overall mean operation time, blood transfusion, operation length, liver function, and postoperative complications, were similar between two groups before and after propensity matching. The postoperative first, third, fifth, and seventh days mean value of aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB), and total bilirubin had no significant difference compared with preoperative value. One patient in each group had recurrence six months after surgery.<br />Conclusion: Right posterior lobe allied with part of V and VIII sectionectomy based on 3-DVT is safe and feasible surgery way, and can be a very promising method in massive or multiple right hepatic malignancy therapy.
- Subjects :
- Adult
Alanine Transaminase blood
Aspartate Aminotransferases blood
Bilirubin blood
Blood Transfusion
Feasibility Studies
Female
Humans
Imaging, Three-Dimensional
Liver physiopathology
Male
Middle Aged
Neoplasm Recurrence, Local surgery
Neoplasm, Residual
Operative Time
Postoperative Complications etiology
Serum Albumin metabolism
Tomography, X-Ray Computed
Hepatectomy adverse effects
Hepatectomy methods
Liver Neoplasms diagnostic imaging
Liver Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1557-9034
- Volume :
- 28
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of laparoendoscopic & advanced surgical techniques. Part A
- Publication Type :
- Academic Journal
- Accession number :
- 29172950
- Full Text :
- https://doi.org/10.1089/lap.2017.0479