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Langenbeck's Archives of Surgery

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01-05-2009 | Original Article

How to operate a liver tumor you cannot see

Authors: Karl J. Oldhafer, Gregor A. Stavrou, Guido Prause, Heinz-Otto Peitgen, Tim C. Lueth, Stefan Weber

Published in: Langenbeck's Archives of Surgery | Issue 3/2009

Abstract

Backround

As recent chemotherapy regimens for metastatic colorectal cancer become more and more effective in a neoadjuvant setting before liver surgery, a “complete” clinical response is sometimes documented on imaging. Without operation though, metastatic recurrence is likely to commence within 12 months. Surgeons now face the problem to resect non-visualizable and non-palpable lesions.

Methods

Computer-based virtual surgery planning can be used to fuse pre- and postchemotherapy computed tomography data to develop an operative strategy. This information is then intraoperatively transferred to the liver surface using an image-guided stereotactically navigated ultrasound dissector. This enables the surgeon to perform a resection that is otherwise not possible.

Results

During operation, detection of the lesion through palpation or ultrasound was impossible. After registering the virtual operation plan into the navigation system, the planned resection was performed without problems. Histopathologic workup showed vital tumor cells in the specimen.

Conclusion

The new image-guided stereotactic navigation technique combined with virtual surgery planning can solve the surgeon’s dilemma and yield a successful operation.

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Title: How to operate a liver tumor you cannot see
Authors: Karl J. Oldhafer
Gregor A. Stavrou
Guido Prause
Heinz-Otto Peitgen
Tim C. Lueth
Stefan Weber
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 3/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-009-0469-9

At a glance: The STEP trials

Springer Medicine

How to operate a liver tumor you cannot see

Abstract

Backround

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Backround

Methods

Results

Conclusion

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