1/4. Surgical treatment of hepatic caudate lobe metastases originating from colorectal primaries.Malignant tumor resection of the hepatic caudate lobe has recently received attention. However, there are few reports about metastatic liver tumor in the caudate lobe from colorectal carcinoma, and its clinical features still remain unknown. In this paper, three patients operated on in our institute and 15 reported cases from the published literature were analyzed in order to reveal clinical features of this disease. Many cases had advanced liver tumors, such as invasion in to major vessels at the time of operation. Isolated complete caudate lobectomy was performed in 8 patients and major hepatectomy was carried out in 6 instances. Seven cases also underwent partial resection of the inferior vena cava. recurrence of disease was observed in 11 patients: seven cases had relapse only in the residual liver, five of whom underwent another hepatectomy. The median survival time of those patients who died was 25 months, and that of seven cases with IVC resection, 18 months. Two patients out of five who received a second hepatectomy survived for longer than 90 months. It is suggested that aggressive surgical treatment including repeated hepatectomy results in the prolongation of survival. Earlier diagnosis and surgical treatment at a more appropriate stage of the disease may further improve the survival rate.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/4. Early experience employing a linear hepatic parenchyma coagulation device.BACKGROUND: In recent years, hepatic resection for primary and metastatic disease has been facilitated by improved anesthetic and surgical techniques, as well as by the application of new technologies. Historically, the major complications associated with hepatic resection have been postoperative bleeding, bile leak, and liver failure. Resection techniques and devices that minimize hemorrhage and bile leak, and enable the preservation of functional hepatic parenchyma, have been useful in the surgical management of liver tumors. methods: Herein, the use of a radiofrequency powered device for the pretransection coagulation of hepatic tissue that simultaneously seals blood vessels and bile ducts 3 mm in diameter or smaller is described. RESULTS: Early results from our single-center experience with the use of this linear radiofrequency device are reported. Seven patients underwent liver resection for either hepatocellular carcinoma or colorectal cancer metastases. There were no postoperative bile leaks, hemorrhage, or hepatic insufficiency. No transfusions were required, and the mean estimated blood loss for the parenchymal transection phase was less than 165 cc. CONCLUSIONS: The linear radiofrequency device is expedient for the pretransection coagulation of hepatic tissue and, thus, facilitates liver resection.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/4. Decrease in circulating anti-angiogenic factors (angiostatin and endostatin) after surgical removal of primary colorectal carcinoma coincides with increased metabolic activity of liver metastases.Removal of a primary colorectal tumor resulted in an increase in metabolic activity in its liver metastasis. Concomitantly, levels of angiostatin and endostatin in urine and plasma, respectively, dropped. This finding indicates that the primary tumor suppressed angiogenesis in its distant metastasis, and that removal of the primary lesion caused a flare-up in vessel neoformation and, thus, enhanced metabolic activity in its liver metastasis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/4. Metastatic liver tumor with tumor thrombi of the portal vein.Tumor thrombi of the portal vein are an important prognostic indicator for primary hepatocellular carcinoma (hepatoma), and their presence is a major criterion in differentiating intrahepatic tumors. We report four cases of metastatic liver tumors with tumor thrombi, one a gastric tumor and the others colorectal cancers, two of which were difficult to differentiate from hepatoma. The angiographic features of hepatoma are reviewed and differentiation between the two is discussed. angiography showed the vessels of metastatic liver tumors to be of fine to mixed types. Chaotic vessels and pooling are characteristic of hepatomas, and dense tumor stains are observed only in hepatomas. The mean survival period after angiography was 3.8 months, and the prognosis was not favorable in patients having "thread-and-streak" sign on angiography.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |