TY - JOUR
T1 - Anatomical segmental and subsegmental resection of the liver for hepatocellular carcinoma
T2 - A new approach by means of ultrasound-guided vessel compression
AU - Torzilli, Guido
AU - Procopio, Fabio
AU - Cimino, Matteo
AU - Del Fabbro, Daniele
AU - Palmisano, Angela
AU - Donadon, Matteo
AU - Montorsi, Marco
PY - 2010/2
Y1 - 2010/2
N2 - Background: Anatomic resection is considered the gold standard approach for liver resection in patients with hepatocellular carcinoma. The use of intraoperative ultrasound (IOUS) as guidance is indispensable in this sense but methods available up to now were rather complex and for that reason of limited use. We herein describe a novel technique for the demarcation of the resection area by means of IOUS-guided finger compression to systematically accomplish anatomic segmental and subsegmental resections. Methods: Thirty-three patients met the eligibility criteria. This technique consisted in the demarcation of the resection area by IOUS-guided finger compression of the vascular pedicle feeding the tumor at the level closest to the tumor but oncologically suitable. Median age was 65 years (range, 36-81). There were 25 men and 8 women. Median tumor number was 1 (range, 1-2); median tumor size was 2 cm (range, 1-10). Twenty-five (76%) patients had cirrhosis or chronic hepatitis, and 8 (24%) had steatosis (ClinicalTrials.Gov ID: NCT00829335). Results: Procedure resulted feasible in all eligible patients, and demarcation area was obtained in all patients within 1 minute of bimanual IOUS-guided compression. There was no mortality or major morbidity: only 7 (21%) patients experienced minor morbidity. No blood transfusions were administered. Conclusions: Systematic segmentectomy and subsegmentectomy by IOUS-guided finger compression is a feasible, safe, and effective technique, which could be considered as a simpler alternative to those up to now proposed.
AB - Background: Anatomic resection is considered the gold standard approach for liver resection in patients with hepatocellular carcinoma. The use of intraoperative ultrasound (IOUS) as guidance is indispensable in this sense but methods available up to now were rather complex and for that reason of limited use. We herein describe a novel technique for the demarcation of the resection area by means of IOUS-guided finger compression to systematically accomplish anatomic segmental and subsegmental resections. Methods: Thirty-three patients met the eligibility criteria. This technique consisted in the demarcation of the resection area by IOUS-guided finger compression of the vascular pedicle feeding the tumor at the level closest to the tumor but oncologically suitable. Median age was 65 years (range, 36-81). There were 25 men and 8 women. Median tumor number was 1 (range, 1-2); median tumor size was 2 cm (range, 1-10). Twenty-five (76%) patients had cirrhosis or chronic hepatitis, and 8 (24%) had steatosis (ClinicalTrials.Gov ID: NCT00829335). Results: Procedure resulted feasible in all eligible patients, and demarcation area was obtained in all patients within 1 minute of bimanual IOUS-guided compression. There was no mortality or major morbidity: only 7 (21%) patients experienced minor morbidity. No blood transfusions were administered. Conclusions: Systematic segmentectomy and subsegmentectomy by IOUS-guided finger compression is a feasible, safe, and effective technique, which could be considered as a simpler alternative to those up to now proposed.
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U2 - 10.1097/SLA.0b013e3181b7fdcd
DO - 10.1097/SLA.0b013e3181b7fdcd
M3 - Article
C2 - 19838106
AN - SCOPUS:77449116737
VL - 251
SP - 229
EP - 235
JO - Annals of Surgery
JF - Annals of Surgery
SN - 0003-4932
IS - 2
ER -