Original communicationSurgical treatment for colorectal liver metastases involving the paracaval portion of the caudate lobe
Section snippets
Patients
Between July 1977 and December 2002, 95 consecutive patients with colorectal hepatic metastases underwent hepatic resection at the Department of Surgery, Nagoya University Hospital, and the Department of Surgery, Tohkai Hospital. Seven of the 95 patients had liver metastases involving S1r, and these 7 patients were reevaluated in this study to confirm the significance of aggressive surgical treatments for these neoplasms. There were 6 men and 1 woman, with a median age of 57 years (range, 54-82
Results
The median operating time was 588 minutes (range, 304-890 minutes), and the median operative blood loss was 2890 mL (range, 950-3325 mL). Neither operative death nor major postoperative complications occurred. As for minor complications, pleural effusion occurred in 2 patients and wound infection in 1 (Table).
Adjuvant chemotherapy was not always performed after resection. Only 1 patient (patient 3) received adjuvant intravenous chemotherapy (5-flourouracil; Kyowa Hakko Kogyo Co Ltd, Japan) and
Discussion
Surgical treatment for patients with hepatic neoplasms in S1r remains a great challenge because S1r is not only situated deep in the liver but is also adjacent to the hepatic hilar structures, the major hepatic veins, and the IVC. In our series, surgical approaches included 3 isolated caudate lobectomies: 1 right hepatectomy and 2 right trisectionectomies with caudate lobectomy. The surgical procedures used depended on tumor location, size, and extent of the involvement of the major hepatic
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A comprehensive study and extensive review of the Caudate lobe: The last piece of “Jigsaw” puzzle
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2014, European Journal of RadiologyCitation Excerpt :However, resection also has limitations if it is used to treat HCC patients with unfavorable tumor locations. As report goes, resections for malignant zones close to main hepatic veins or the vena cava are sometimes practicable[6,7], but they are always associated with increased risks [8]. The emergence of local thermal ablation provides a feasible choice for these patients [9–13].
Isolated caudate lobe resection for hepatic tumor: Surgical approaches and perioperative outcomes
2010, American Journal of SurgeryCitation Excerpt :There was no alternative but left-sided approach for isolated resection of SL and right-sided approach for isolated resection of the CP. Perhaps the PP was the most difficult part to access among the 3 portions of caudate lobe.12,15 Some authors used left-sided, right-sided, and anterior approaches for resection of hepatic tumor in the PP, in which extensive mobilization of the liver and dissection of the IVC had been done before resection of the tumor using an anterior approach.
The impact of caudate lobe involvement after hepatic resection for colorectal metastases
2009, European Journal of Surgical OncologyA comparison of right and extended right hepatectomy with all other hepatic resections for colorectal liver metastases: A ten-year study
2009, European Journal of Surgical OncologyCitation Excerpt :The number of patients who received blood transfusions during the intra- and post-operative periods was not significantly different between groups although blood loss was higher in the RH group suggesting that these procedures are technically more difficult and thus have a greater operative risk. Yamamoto et al.25 reported that right-sided hepatectomies and caudate lobe procedures were technically more difficult, in part due to the close proximity of hepatic veins and inferior vena cava. However, they concluded that resections could be performed safely with good oncological results.