Sustained methylene blue staining to guide anatomic hepatectomy for hepatocellular carcinoma: Initial experience and technical details

Surgery
Cai Shou-wangDong Jia-hong

Abstract

The boundary of the target hepatic segment within the liver parenchyma cannot be marked by the use of a conventional anatomic hepatectomy approach. This study describes a novel methylene blue staining technique for guiding the anatomic resection of hepatocellular carcinoma (HCC). Between February 2009 and February 2012, anatomic hepatectomy was performed in 106 patients with HCC via a novel, sustained methylene blue staining technique. Sustained staining was achieved by injecting methylene blue into the distal aspect of the portal vein after exposing Glisson's sheath. The hepatic pedicle was immediately ligated, and the hepatic parenchymal transection was performed along the interface between methylene blue stained tissue and unstained tissue. Anatomic hepatectomies included subsegmentectomy (n = 16), monosegmentectomy (n = 57), multisegmentectomy (n = 27), and hemihepatectomy (n = 6). The portal vein was injected successfully with methylene blue in 100% of cases, and complete staining of the target hepatic segment was achieved in 98 of 106 (92.5%) cases. Mean intraoperative bleeding was 360 ± 90 mL, and the postoperative complication rate was 24.5% (26/106). No perioperative mortality occurred. Operative margins were all negat...Continue Reading

References

Jul 1, 1993·Seminars in Surgical Oncology·M MakuuchiS Kawasaki
Jan 9, 1999·Journal of Hepato-biliary-pancreatic Surgery·K Takasaki
Mar 22, 2002·The Lancet Oncology·D M Parkin
Dec 19, 2002·Journal of Computer Assisted Tomography·Lars FischerWolfram Lamadé
May 9, 2003·Surgical Oncology Clinics of North America·Guido Torzilli, Masatoshi Makuuchi
Apr 6, 2004·The Surgical Clinics of North America·K H LiauR P DeMatteo
Jul 26, 2005·Annals of Surgery·Kiyoshi HasegawaMasatoshi Makuuchi
Jan 26, 2007·Annals of Surgical Oncology·Toshifumi WakaiKatsuyoshi Hatakeyama
Mar 27, 2007·Surgery·Marcel Autran C MachadoMarcel C C Machado
Apr 13, 2007·The New England Journal of Medicine·Pierre-Alain ClavienRolf Graf
Jun 16, 2007·Gastroenterology·Hashem B El-Serag, K Lenhard Rudolph
Dec 29, 2011·Annals of Surgical Oncology·Yo-ichi YamashitaYoshihiko Maehara
Jan 21, 2014·Surgery·Alessandro CucchettiAntonio Daniele Pinna

❮ Previous
Next ❯

Citations

Oct 27, 2015·The Journal of Surgical Research·Jianpeng LiYi Lv
Sep 3, 2017·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·T J CudaA R L Stevenson
Mar 28, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Junxiang WangYimao Zhang
Feb 3, 2021·Journal of Hepato-biliary-pancreatic Sciences·Mamoru MorimotoUNKNOWN Study group of Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic surgery (PAM-HBP surgery)

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.