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[Hepatectomy with an additional parasternal incision without thoracotomy].
Takeshi Tono1, Toshiyuki Kanoh, Kazuyuki Okada
1Department of Surgery, NTT West Osaka Hospital, Osaka, Japan.
Nihon Geka Gakkai Zasshi
|November 6, 2002
Summary
This study introduces a novel surgical approach for liver cancer, utilizing a parasternal incision for improved access to the liver and hepatic veins. This technique offers a safe alternative to thoracotomy for liver surgery.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Minimally Invasive Techniques
Background:
- Hepatocellular carcinoma (HCC) diagnosis in liver segment 8 necessitates effective surgical resection.
- Standard surgical approaches may present challenges in achieving optimal exposure of the subphrenic liver, particularly around the hepatic veins.
Observation:
- A modified surgical access involving a right parasternal skin incision combined with a median incision was employed.
- This approach included division of two costal cartilages to enhance visualization of the subphrenic liver area.
Findings:
- The technique provided excellent exposure of the subphrenic liver, including the critical root of the hepatic veins.
- In a series of 7 patients undergoing partial hepatectomy for HCC, this method consistently achieved a satisfactory operative field.
- The procedure was performed without the need for thoracotomy.
Implications:
- This parasternal incision technique offers a valuable, less invasive alternative for liver access.
- It is particularly beneficial for procedures requiring meticulous isolation around the root of the hepatic veins.
- This approach may improve surgical outcomes and reduce patient morbidity in select liver cancer resections.