Transthoracic approach for liver tumors

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Minimally Invasive Procedures

Background:

• The abdominal approach is standard for liver tumor resection.
• Lesions in the hepatic dome or involving the cavo-hepatic junction present unique surgical challenges.
• Alternative approaches are needed for select patient populations.

Purpose of the Study:

• To evaluate the transthoracic approach as a management option for specific liver tumor locations.
• To assess the feasibility and outcomes of open, thoracoscopic, and percutaneous transthoracic liver tumor treatments.
• To identify patient groups who may benefit from this approach.

Main Methods:

• Review of transthoracic procedures for liver tumors, including thoracotomomy, thoracoscopy, and CT-guided radiofrequency ablation.
• Analysis of suitability for limited liver resections (tumorectomy, segmentectomy) and percutaneous ablation therapies.
• Consideration of application in high-risk patients, those with prior abdominal surgery, and as a bridge to liver transplantation.

Main Results:

• The transthoracic approach is a viable option for cranially located single liver lesions.
• It is particularly useful for high-risk patients or those awaiting liver transplantation.
• Both limited liver resection and percutaneous ablation (radiofrequency, cryotherapy) can be performed with acceptable morbidity.

Conclusions:

• The transthoracic approach is an important alternative for managing select liver tumors, especially in the hepatic dome.
• It offers minimally invasive and percutaneous options, expanding treatment possibilities.
• This approach provides a valuable strategy for complex cases and specific patient groups.