PMID: 8943183Jan 1, 1997Paper

Transthoracic transdiaphragmatic approach for hepatectomy of Couinaud's segments VII and VIII

World Journal of Surgery
S KoH Nakano

Abstract

For hepatectomy of Couinaud's segment VII or VIII, severe compression and mobilization of the liver is required to establish the operative field via the usual transabdominal approach. Compression of the cirrhotic liver impairs hepatic and systemic blood circulation, which may cause liver dysfunction. We adopted a transthoracic transdiaphragmatic approach for hepatectomy of segment VII or VIII in cirrhotic patients to establish a good operative field without compressing the liver. The aim of this study was to evaluate the benefits of this approach. Forty-four patients with hepatocellular carcinoma (HCC) complicating liver cirrhosis who underwent limited hepatectomy of Couinaud's segment VII or VIII were studied. The patients were randomized to two groups preoperatively: group I (n = 22), transabdominal approach; group II (n = 22), transthoracic transdiaphragmatic approach. There were no differences in preoperative liver function tests, hepatic functional reserve, or extent of tumor between the two groups. The operative time in group II was significantly shorter than that in group I (243 +/- 50 versus 313 +/- 80 minutes;p < 0.01). Operative blood loss in group II was also significantly smaller than that in group I (1190 +/- 1098 ...Continue Reading

Citations

Feb 1, 2012·Langenbeck's Archives of Surgery·F CauchyJ Belghiti
Dec 20, 2011·Surgical Endoscopy·Jordan M Cloyd, Brendan C Visser
Mar 22, 2003·Journal of the American College of Surgeons·Feng XiaJohn Wong
Mar 17, 1999·Annals of Surgery·S T FanJ Wong
May 30, 2002·Annals of Surgery·Robert C G MartinDavid P Jaques
Sep 28, 2014·Best Practice & Research. Clinical Gastroenterology·François CauchyJacques Belghiti
Aug 3, 2012·World Journal of Surgery·Safi DokmakJacques Belghiti
Dec 18, 2013·Updates in Surgery·Matteo DonadonGuido Torzilli
Mar 21, 2007·Journal of Surgical Oncology·Spiros G DelisChristos Dervenis
Jun 4, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Li QinLi Bo
Dec 14, 2011·Journal of Visceral Surgery·N GolseJ Y Mabrut

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