Unusual Techniques for Preserving Surgical and Oncologic Safety in Hepatectomy of Advanced Adrenal Malignancy with Vena Cava and Liver Invasion

Annals of Surgical Oncology
Jeong-Moo LeeKyung-Suk Suh

Abstract

Status in terms of major vascular structure invasion is a crucial factor for successful major hepatic resection. In particular, surgery for advanced tumors with inferior vena cava (IVC) invasion is difficult and may even be dangerous for the patient, having high risk of massive bleeding and greater chance of embolic complications such as stroke, bowel ischemia, and pulmonary venous thrombosis. For such reasons, many surgeons hesitate to carry out such surgical resection, and even if they do so, may not totally remove the tumor including the part inside the IVC, achieving R1 resection. For safe and radical surgery, various surgical techniques are required. We report herein three cases of major hepatectomy with IVC invasion and discuss several surgical tips. From March 2011 to February 2014, we retrospectively reviewed three cases of adrenal malignancy with liver and IVC invasion. Based on the severity of the malignant tumor, each case illustrates a different method to address surgical complications and maintain oncologic safety. Case 1: A 34-year-old woman was diagnosed with adrenocortical tumor during medical examination. Tumor invaded the right lobe of the liver and very close to the IVC. Fortunately, there was little thrombos...Continue Reading

References

Sep 20, 2011·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·G NuzzoJ Figueras
Jun 8, 2013·Hepatobiliary & Pancreatic Diseases International : HBPD INT·Ai-Jun LiMeng-Chao Wu
Oct 8, 2013·World Journal of Surgical Oncology·Kenji WakayamaAkinobu Taketomi

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Citations

Feb 11, 2020·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Juping ZhaoFukang Sun
Sep 27, 2020·Langenbeck's Archives of Surgery·Maria Baimas-GeorgeDionisios Vrochides

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