Related Experiment Video
Updated: Jan 11, 2026
Laparoscopic Anatomic S7+S8d Resection Preserving Inferior Right Hepatic Vein and S6 with Right Hepatic Vein Transection
Published on: December 30, 2025
Aggressive hepatic vein resection aimed at achieving R0 resection for colorectal liver metastases remains crucial
Yoshihito Hayashi1, Junichi Kaneko1, Yui Sawa1
1Hepato-Biliary-Pancreatic Surgery Division, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Background:
The significance of aggressive hepatic vein (HV) resection and suitable reconstruction for colorectal liver metastases (CLMs) remains unclear.
Methods:
The retrospectively collected hospital surgical patient data were obtained from consecutive patients who underwent liver resections for CLM between January 2010 and December 2022. A total of 628 liver resections were performed for CLMs and 395 of these were first liver resections. Fifty-four patients underwent HV or inferior vena cava resection and reconstruction for CLM invasion (VR group), and the remaining 341 patients had no venous reconstruction (NR group).
Results:
Multivariate analysis showed that only tumor size ≥5 cm and R1 vascular were prognostic risk factors for overall survival (OS). Although the 1-, 3-, and 5-year OS of the VR group was poorer than that of the NR group (92.2 %, 67.2 %, 37.9 % vs 97.0 %, 76.6 %, 64.4 %, P < 0.001), there was no significant difference between the NR-propensity score matching (PSM) and VR-PSM analysis groups (P = 0.220).
Conclusions:
R0-intent aggressive hepatic vein (HV) resection and appropriate reconstruction for CLMs may still be essential. Achieving an R0 resection remains a key objective, while the acceptability of R1 vascular resection continues to be debated.
