Secondary Malignant Neoplasm of Liver
Conditions
Brief summary
Major hepatectomies are generally selected for tumors involving the hepatic vein (HV) at the caval confluence (CC). As alternative, HV reconstruction has been proposed. The present study aimed to evaluate the feasibility and safety of a HV-sparing policy guided by intraoperative ultrasonography (IOUS) in a cohort of patients having at least one colorectal liver metastasis (CLM) in contact with a HV at CC. HV section can be avoided in the large majority of cases thanking to CLMs detachment or to HV partial resection or reconstruction: this policy seems feasible, safe, reduces the need of major hepatectomies, and oncologically provides an adequate local control.
Interventions
PROCEDUREHepatic vein-sparing hepatectomy
HV detachment, partial resection and section on the basis of HV-CLM relationship
Sponsors
University of Milan
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
28 Years to 79 Years
Healthy volunteers
No
Inclusion criteria
* diagnosis of at least one CLM in contact with HV at caval confluence and HV patency at preoperative imaging * at least 6 months of follow-up after surgery
Exclusion criteria
* suspected or ascertained thrombosis or full tumoral involvement of HV at preoperative imaging * portal pedicle infiltration and/or thrombosis * unresectability at laparotomy for any extra-hepatic or intrahepatic reason not related to tumor-vessel relations
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the safety of HV-sparing surgery in terms of operative mortality and morbidity | within 30-90 days after surgery |
Countries
Italy
Outcome results
None listed