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Published in: Journal of Gastrointestinal Surgery 10/2012

01-10-2012 | How I do it

Conformational Technique for Non-Anatomic Resection of Liver Lesions

Authors: Peter J. DiPasco, Subhasis Misra, Leonidas G. Koniaris

Published in: Journal of Gastrointestinal Surgery | Issue 10/2012

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Abstract

Safe margin-negative hepatic resection with maximal preservation of normal liver parenchyma is the primary operative objective in treating patients with metastatic or primary liver malignancies. A technique to perform non-anatomic liver resection(s) for large lesions that may involve major hepatic vascular structures is herein described. This technique employs linear cutting stapler technology and specific mobilization of the liver to perform single or multiple large spherical resections of liver lesions.
Literature
1.
go back to reference Koniaris LG, Levi DM, Pedroso FE, Franceschi D, Tzakis AG, Santamaria-Barria JA, Tang J, Anderson M, Misra S, Solomon NL, Jin X, DiPasco PJ, Byrne MM, Zimmers TA: Is surgical resection superior to transplantation in the treatment of hepatocellular carcinoma? Ann Surg 2011;254:527-537; discussion 537-528.PubMedCrossRef Koniaris LG, Levi DM, Pedroso FE, Franceschi D, Tzakis AG, Santamaria-Barria JA, Tang J, Anderson M, Misra S, Solomon NL, Jin X, DiPasco PJ, Byrne MM, Zimmers TA: Is surgical resection superior to transplantation in the treatment of hepatocellular carcinoma? Ann Surg 2011;254:527-537; discussion 537-528.PubMedCrossRef
2.
go back to reference McKillop IH, Moran DM, Jin X, Koniaris LG: Molecular pathogenesis of hepatocellular carcinoma. J Surg Res 2006;136:125-135.PubMedCrossRef McKillop IH, Moran DM, Jin X, Koniaris LG: Molecular pathogenesis of hepatocellular carcinoma. J Surg Res 2006;136:125-135.PubMedCrossRef
3.
go back to reference Earle SA, Perez EA, Gutierrez JC, Sleeman D, Livingstone AS, Franceschi D, Levi JU, Robbins C, Koniaris LG: Hepatectomy enables prolonged survival in select patients with isolated noncolorectal liver metastasis. J Am Coll Surg 2006;203:436-446.PubMedCrossRef Earle SA, Perez EA, Gutierrez JC, Sleeman D, Livingstone AS, Franceschi D, Levi JU, Robbins C, Koniaris LG: Hepatectomy enables prolonged survival in select patients with isolated noncolorectal liver metastasis. J Am Coll Surg 2006;203:436-446.PubMedCrossRef
4.
go back to reference Wakai T, Shirai Y, Sakata J, Valera VA, Korita PV, Akazawa K, Ajioka Y, Hatakeyama K: Appraisal of 1 cm hepatectomy margins for intrahepatic micrometastases in patients with colorectal carcinoma liver metastasis. Ann Surg Oncol 2008;15:2472-2481.PubMedCrossRef Wakai T, Shirai Y, Sakata J, Valera VA, Korita PV, Akazawa K, Ajioka Y, Hatakeyama K: Appraisal of 1 cm hepatectomy margins for intrahepatic micrometastases in patients with colorectal carcinoma liver metastasis. Ann Surg Oncol 2008;15:2472-2481.PubMedCrossRef
5.
go back to reference Agrawal S, Belghiti J: Oncologic resection for malignant tumors of the liver. Ann Surg 2011;253:656-665.PubMedCrossRef Agrawal S, Belghiti J: Oncologic resection for malignant tumors of the liver. Ann Surg 2011;253:656-665.PubMedCrossRef
6.
go back to reference Koniaris LG, McKillop IH, Schwartz SI, Zimmers TA: Liver regeneration. J Am Coll Surg 2003;197:634-659.PubMedCrossRef Koniaris LG, McKillop IH, Schwartz SI, Zimmers TA: Liver regeneration. J Am Coll Surg 2003;197:634-659.PubMedCrossRef
7.
go back to reference Jin X, Zhang Z, Beer-Stolz D, Zimmers TA, Koniaris LG: Interleukin-6 inhibits oxidative injury and necrosis after extreme liver resection. Hepatology 2007;46:802-812.PubMedCrossRef Jin X, Zhang Z, Beer-Stolz D, Zimmers TA, Koniaris LG: Interleukin-6 inhibits oxidative injury and necrosis after extreme liver resection. Hepatology 2007;46:802-812.PubMedCrossRef
8.
go back to reference Delis SG, Bakoyiannis A, Karakaxas D, Athanassiou K, Tassopoulos N, Manesis E, Ketikoglou I, Papakostas P, Dervenis C: Hepatic parenchyma resection using stapling devices: peri-operative and long-term outcome. HPB (Oxford) 2009;11:38-44.CrossRef Delis SG, Bakoyiannis A, Karakaxas D, Athanassiou K, Tassopoulos N, Manesis E, Ketikoglou I, Papakostas P, Dervenis C: Hepatic parenchyma resection using stapling devices: peri-operative and long-term outcome. HPB (Oxford) 2009;11:38-44.CrossRef
9.
go back to reference Sitzmann JV, Spector SA, Jin X, Barquist E, Koniaris LG: A technique for emergency liver packing. J Gastrointest Surg 2005;9:284-287.PubMedCrossRef Sitzmann JV, Spector SA, Jin X, Barquist E, Koniaris LG: A technique for emergency liver packing. J Gastrointest Surg 2005;9:284-287.PubMedCrossRef
10.
go back to reference Gurusamy KS, Pamecha V, Sharma D, Davidson BR: Techniques for liver parenchymal transection in liver resection. Cochrane Database Syst Rev 2009:CD006880. Gurusamy KS, Pamecha V, Sharma D, Davidson BR: Techniques for liver parenchymal transection in liver resection. Cochrane Database Syst Rev 2009:CD006880.
11.
go back to reference Burdio F, Grande L, Berjano E, Martinez-Serrano M, Poves I, Burdio JM, Navarro A, Guemes A: A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study. Am J Surg 2010;200:e75-80.PubMedCrossRef Burdio F, Grande L, Berjano E, Martinez-Serrano M, Poves I, Burdio JM, Navarro A, Guemes A: A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study. Am J Surg 2010;200:e75-80.PubMedCrossRef
12.
go back to reference Saidi RF, Ahad A, Escobar R, Nalbantoglu I, Adsay V, Jacobs MJ: Comparison between staple and vessel sealing device for parynchemal transection in laparoscopic liver surgery in a swine model. HPB (Oxford) 2007;9:440-443.CrossRef Saidi RF, Ahad A, Escobar R, Nalbantoglu I, Adsay V, Jacobs MJ: Comparison between staple and vessel sealing device for parynchemal transection in laparoscopic liver surgery in a swine model. HPB (Oxford) 2007;9:440-443.CrossRef
13.
go back to reference Rahbari NN, Elbers H, Koch M, Bruckner T, Vogler P, Striebel F, Schemmer P, Mehrabi A, Buchler MW, Weitz J: Clamp-crushing versus stapler hepatectomy for transection of the parenchyma in elective hepatic resection (CRUNSH)—a randomized controlled trial (NCT01049607). BMC Surg 2011;11:22.PubMedCrossRef Rahbari NN, Elbers H, Koch M, Bruckner T, Vogler P, Striebel F, Schemmer P, Mehrabi A, Buchler MW, Weitz J: Clamp-crushing versus stapler hepatectomy for transection of the parenchyma in elective hepatic resection (CRUNSH)—a randomized controlled trial (NCT01049607). BMC Surg 2011;11:22.PubMedCrossRef
Metadata
Title
Conformational Technique for Non-Anatomic Resection of Liver Lesions
Authors
Peter J. DiPasco
Subhasis Misra
Leonidas G. Koniaris
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 10/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-012-1957-8

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