In the case of tumors in contact with or invading the middle hepatic vein (MHV) at the hepatocaval confluence, extended right hepatectomy or mesohepatectomy is usually recommended. Major or extended hepatectomy is associated with significant rates of morbidity and mortality, and a more conservative approach would be desirable. Thus, we developed a new conservative operation, the so-called mini-mesohepatectomy that, in some specific circumstances, allowed the en-bloc resection of segment 8, segment 4-sup and the MHV at the hepatocaval confluence and at the same time preservation of the remaining parenchyma of the right anterior section and left median section drained by the MHV. The present work describes the rationale, indications, as well as the surgical technique of this new operation which we believe should be part of the armamentarium of the modern hepatic surgeon, and will probably limit the need for a formal mesohepatectomy.
From mesohepatectomy to mini-mesohepatectomy : evolving the concept of resectability of hepatic tumors at the hepatocaval confluence [Recensione] / G. Torzilli, M. Donadon. - In: DIGESTIVE SURGERY. - ISSN 0253-4886. - 28:2(2011), pp. 109-113.
|Titolo:||From mesohepatectomy to mini-mesohepatectomy : evolving the concept of resectability of hepatic tumors at the hepatocaval confluence|
TORZILLI, GUIDO (Primo)
DONADON, MATTEO DAVIDE (Ultimo)
|Parole Chiave:||Ultrasonography Interventional ; Liver Neoplasms ; Neoplasm Invasiveness ; Humans ; Hepatectomy ; Hepatic Veins ; Dissection|
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
|Data di pubblicazione:||2011|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1159/000323819|
|Appare nelle tipologie:||01 - Articolo su periodico|