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Surgery for CR mets

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9 papers 25 to 100 followers
Jason T Wiseman, Francisco Guzman-Pruneda, Dimitrios Xourafas, Yun Shin Chun, Aslam Ejaz, Allan Tsung, Timothy M Pawlik, Jordan M Cloyd
BACKGROUND: The role of neoadjuvant chemotherapy in the management of colorectal liver metastases (CRLM) remains controversial. We sought to investigate whether neoadjuvant systemic chemotherapy contributes to clinically significant increases in postoperative morbidity and mortality using a population-based cohort. STUDY DESIGN: The ACS-NSQIP Targeted Hepatectomy Participant Use Files were queried from 2014-2016 to identify patients with CRLM who underwent liver resection...
March 21, 2019: Journal of the American College of Surgeons
C J Isfordink, M Samim, M N G J A Braat, A M Almalki, J Hagendoorn, I H M Borel Rinkes, I Q Molenaar
An important risk of major hepatic resection is postoperative liver failure, which is directly related to insufficient future liver remnant (FLR). Portal vein embolization (PVE) and portal vein ligation (PVL) can minimize this risk by inducing hypertrophy of the FLR. The aim of this systematic review and meta-analysis was to compare the efficacy and safety of PVE and PVL for FLR hypertrophy. A systematic search was conducted on the17th of January 2017. The methodological quality of the studies was assessed using the Oxford Critical Appraisal Skills Program for cohort studies...
September 2017: Surgical Oncology
Claudius Conrad, Jean-Nicolas Vauthey, Okuno Masayuki, Rahul A Sheth, Suguru Yamashita, Guillaume Passot, Christina E Bailey, Daria Zorzi, Scott Kopetz, Thomas A Aloia, Y Nancy You
BACKGROUND: The optimal treatment sequence for patients with advanced rectal cancer and synchronous resectable liver metastases is controversial. We examined the outcomes associated with an individualized selection of classic, reversed, or combined approaches. METHODS: Between 1999 and 2014, 268 patients with rectal cancer and synchronous liver-only metastases underwent curative-intent multimodality therapy. Demographics and tumor and treatment details were reviewed...
December 2017: Annals of Surgical Oncology
Katsunori Imai, Carlos Castro Benitez, Marc-Antoine Allard, Eric Vibert, Antonio Sa Cunha, Daniel Cherqui, Denis Castaing, Henri Bismuth, Hideo Baba, René Adam
OBJECTIVE: To evaluate the impact of repeat surgery for recurrence on the long-term survival after 2-stage hepatectomy (TSH) for extensive colorectal liver metastases (CRLM). BACKGROUND: Although TSH is now deemed effective for selected patients with extensive bilobar CRLM, disease recurrence after TSH is very frequent because of the extensive tumor load. METHODS: Among a total cohort of 1235 patients who underwent hepatectomy for CRLM between 1992 and 2012, 139 with extensive bilobar CRLM were scheduled for TSH...
August 17, 2017: Annals of Surgery
Jonathan S Abelson, Fabrizio Michelassi, Tianyi Sun, Jialin Mao, Jeffrey Milsom, Benjamin Samstein, Art Sedrakyan, Heather L Yeo
BACKGROUND: Optimal surgical management for patients with synchronous colorectal cancer liver metastasis is controversial. We provide an analysis of surgical utilization and outcomes for patients presenting with synchronous colon and rectal cancer liver metastasis between simultaneous and staged approaches. METHODS: SPARCS database was used to follow patients undergoing surgery for colorectal cancer with liver metastases from 2005 to 2014. Using International Classification of Diseases, Ninth Revision codes, we identified patients undergoing staged and simultaneous resection...
June 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Leonid Barkhatov, Åsmund A Fretland, Airazat M Kazaryan, Bård I Røsok, Kristoffer W Brudvik, Anne Waage, Bjørn A Bjørnbeth, Mushegh A Sahakyan, Bjørn Edwin
OBJECTIVE: The aim of this study was to validate clinical risk scores in patients underwent laparoscopic resection of colorectal liver metastases (CLM) with 5 years follow-up or more, and assess 5- and 10-year actual survival in this group. METHODS: A total of 516 laparoscopic liver resections were performed in 406 patients with CLM between February 1998 and September 2015. A follow-up of 5 and 10 years could be assessed in 144 and 29 patients, respectively. The Fong score, pre- and postoperative Basingstoke Predictive Index (BPI), Nordlinger score, and Iwatsuki score were validated...
November 2016: Journal of Surgical Oncology
Lee M Ocuin, Allan Tsung
Utilization of robotic techniques for resection of the liver is slowly gaining acceptance in specific situations and is now being applied to more challenging endeavors, such as major hepatectomy for cancer. This review provides a summary of robotic applications in liver surgery, with specific attention perioperative outcomes, oncologic outcomes, cost, and comparison to conventional laparoscopic techniques of liver resection. We also discuss future applications of robotic-assisted liver surgery.
September 2015: Journal of Surgical Oncology
Neda Amini, Yuhree Kim, Omar Hyder, Gaya Spolverato, Christopher L Wu, Andrew J Page, Timothy M Pawlik
BACKGROUND: We sought to define trends in the use of epidural analgesia (EA) for hepatopancreatic procedures, as well as to characterize inpatient outcomes relative to the use of EA. METHODS: The Nationwide Inpatient Sample database was queried to identify all elective hepatopancreatic surgeries between 2000 and 2012. In-hospital outcomes were compared among patients receiving EA vs conventional analgesia using propensity matching. RESULTS: EA utilization was 7...
September 2015: American Journal of Surgery
Guido Torzilli, Fabio Procopio, Matteo Cimino, Matteo Donadon, Daniele Del Fabbro, Guido Costa, Carlos A Garcia-Etienne
BACKGROUND: Two-stage hepatectomies generally are selected for patients with multiple bilobar colorectal liver metastases (CLMs) involving the hepatic veins (HV) at the caval confluence to reduce the risk of postoperative hepatic failure due to insufficient remnant liver.1 (,) 2 The use of IOUS based on well-established criteria offers alternative technical solutions to the staged resections.3 (,) 4 This report describes a sophisticated IOUS-guided parenchyma-sparing procedure. METHODS: A 57-year-old woman with multiple CLMs underwent surgery...
May 2015: Annals of Surgical Oncology
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