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Middle hepatic vein reconstruction using a peritoneal patch: report of a case
Koho Akimaru1, Masahiko Onda, Takashi Tajiri
1First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Surgery Today
|March 2, 2002
Summary
This study highlights the successful surgical removal of sigmoid colon cancer with liver metastases. Venous reconstruction using a peritoneal patch ensured long-term liver function and patient survival.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- Colorectal cancer frequently metastasizes to the liver, necessitating complex surgical interventions.
- Surgical resection of liver metastases offers the potential for improved survival in select patients.
- Middle hepatic vein (MHV) involvement presents a surgical challenge during liver resection.
Observation:
- A 67-year-old male presented with sigmoid colon cancer and multiple liver metastases.
- Initial surgery included sigmoidectomy and left hepatectomy with enucleation of metastases.
- Resection and reconstruction of the invaded MHV using a peritoneal patch were performed.
Findings:
- No lymph node metastasis was detected histologically after sigmoidectomy.
- A single liver metastasis recurred 13 months postoperatively and was successfully excised.
- The reconstructed MHV remained patent for 24 months, ensuring adequate liver drainage.
Implications:
- Resection of liver metastases, including venous reconstruction, can lead to prolonged survival.
- Peritoneal grafts are a viable option for hepatic vein repair.
- Aggressive surgical management of colorectal liver metastases can achieve favorable long-term outcomes.