Format:
1 Online-Ressource (383 pages)
ISBN:
9783319138961
Content:
Foreword -- Preface -- Contents -- Contributors -- Part I: Global Patient Evaluation and Oncological Assessment -- 1: Liver Surgical Anatomy -- Introduction -- Classical Surgical Anatomy of the Liver -- Functional (Vascular) Anatomy -- Alternative Representations -- A More Independent Look at the Anatomies of the Liver -- Surgical Anatomy and Anatomical Surgery of the Structures and Planes in the Liver -- The Hilar Plate -- Approaches to the Portal Pedicles -- Arantius' Ligament -- Approaches to the Hepatic Veins -- Segment 1 -- Segment 8 -- References -- 2: Resectability Assessment with Diagnostic Imaging -- Introduction -- Selection of Patients -- Assessment of Resectability Based on Imaging -- Imaging -- Ultrasound -- CT -- MRI -- FGD-PET -- References -- 3: Preoperative Evaluation of Liver Function -- Introduction -- Definition of Liver Function -- Passive Liver Function Tests -- Aminotransaminases -- Bilirubin -- Albumin and Coagulation Factor Synthesis -- Ammonia Elimination and Urea Production -- Hyaluronic Acid Clearance -- Clinical Grading Systems -- Child-Pugh Score -- MELD (Model for End-Stage Liver Disease) Score -- Volumetric Measurements: the Gold Standard -- Standardized CT Volumetry -- Body Weight Ratio -- Dynamic Quantitative Liver Tests -- Indocyanine Green Clearance Test -- Galactose Elimination Capacity (GEC) Test -- Lidocaine Clearance (MEGX) Test -- Scintigraphic Liver Function Tests -- 99mTc-GSA Scintigraphy -- HBS with IDA Derivates -- Other Modalities for Assessment of Liver Function -- Bioenergetic Tests -- 13C-Methacetin Breath Test, LiMAx -- Assessment of Liver Function Using Magnetic Resonance Imaging -- Discussion -- References -- 4: Imaging-Based Preoperative Planning -- Introduction -- Oncological Resectability -- Imaging Techniques -- Ultrasound -- Intraoperative Ultrasound -- Computed Tomography -- MRI
Content:
FDG-PET-CT -- Imaging-Based Assessment of Oncological Resectability in a Multimodal Treatment Setting -- Impact of Preoperative Chemotherapy on the Diagnostic Performance of Liver Imaging -- Radiological Assessment of the Oncological Response to Preoperative Chemotherapy -- Preoperative Radiological Assessment of Pathologic Response -- Complete Radiologic Response or the Disappeared Liver Metastasis -- Functional Resectability -- Assessment of the Functional Liver Remnant -- Volumetric Assessment of the Liver -- Enzymatic Liver Function Testing -- Imaging-Based Liver Function Testing -- Computer-Assisted Virtual Resection Planning in the 3D Liver Model -- References -- 5: Choosing the Best Strategy -- Introduction -- Patient Selection -- General Evaluation -- Local Evaluation -- Choosing the Best Strategy -- Imaging Considerations -- Chemotherapy Considerations -- Surgical Considerations -- References -- Part II: Non-operative Multimodal Therapies -- 6: Conversion and Neoadjuvant Therapies -- Introduction -- Chemotherapeutic Agents: Overview and Toxicity -- Molecular Targeted Agents: Overview and Toxicity -- Criteria to Define Resectability in Colorectal Liver Metastases -- Response Imaging Evaluation in Colorectal Liver Metastases -- Disappearing Liver Metastases and Tumor Response -- Neoadjuvant Chemotherapy and Resectable Colorectal Liver Metastases -- Conversion Chemotherapy in Unresectable Colorectal Liver Metastases -- Adjuvant Chemotherapy in Colorectal Liver Metastases -- Liver Recurrence and Chemotherapy -- References -- 7: Portal Vein Embolization -- The Future Liver Remnant and the Rationale for Portal Vein Embolization -- Surgical Strategy and Preoperative Assessment of FLR -- Evaluation of Candidates for Portal Vein Embolization -- Preoperative Assessment of FLR -- Techniques of Portal Vein Embolization -- Accessing the Portal Vein
Content:
Agents Used for Embolization and the Technique -- Embolization of Segment 4 Portal Vein Branches -- Measuring Effect and Outcome After Portal Vein Embolization -- Degree of Hypertrophy -- Kinetic Growth Rate -- Salvage Options After PVE Failure -- Complications After PVE -- Oncologic Impact of PVE and Effect of Chemotherapy -- Alternatives to Portal Vein Embolization and Additional Techniques to Induce Liver Hypertrophy -- Associating Liver Partition and Portal Vein Ligation -- Portal Vein Ligation -- Summary -- References -- 8: Intra-Arterial Chemotherapy -- Introduction -- Rationale for Intra-Arterial Chemotherapy -- Hepatic Arterial Infusion (HAI) Pump Therapy -- Technical Considerations -- Alternative Modes of Intra-Arterial Chemotherapy -- Outcomes in Unresectable Disease -- Outcomes as Adjuvant Therapy Following Hepatic Resection -- Complications -- References -- 9: Radioembolization -- Introduction -- Principles and Technique of Radioembolization -- Indications, Contraindications, and Patient Selection -- Efficacy and Clinical Results -- Radioembolization as First-Line Treatment -- Radioembolization as Second-Line Treatment -- Radioembolization as Salvage Treatment -- Side-Effects and Complications -- Follow-Up and Response Assessment -- References -- Part III: Surgical Strategies -- 10: Anesthetic Management -- Introduction -- Anatomy and Hepatic Physiology -- Anatomic and Physiological Characteristics of the Liver with Surgical and Anaesthetic Relevance -- Hepatic Endothelium and Influence on Central Venous Pressure -- Surgical Manoeuvres that Diminish Intraoperative Bleeding -- Pringle Manoeuvre (PM) -- Total Vascular Exclusion (TVE) -- Anaesthetic Technique -- Relationship Between Central Venous Pressure (CVP) and Intraoperative Haemorrhage -- Other Causes that Can Influence Intraoperative Bleeding -- Patients with Preoperative Morbility
Content:
Other Strategies to Diminish Bleeding -- Hepatic Injury due to Ischemia: Pre Conditioning -- Post-operative Analgesia and Fast Track Technique -- Ex-Situ, Ex-Vivo Hepatic Resection -- Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy-ALPPS -- Final Considerations -- References -- 11: Intraoperative Evaluation of Resectability -- Introduction -- Surgical Technique -- Incision -- IOUS Intraoperative Staging -- Mobilization -- Tumor-Vessel Detachment -- Flow Analyses -- New Operations -- Systematic Extended Right Posterior Sectionectomy -- Eligibility Criteria -- Procedure -- Minimesohepatectomy -- Eligibility Criteria -- Procedure -- Upper Transversal Hepatectomy (UTH) -- Eligibility Criteria -- Procedure -- Liver Tunnel -- Eligibility Criteria -- Procedure -- References -- 12: Vascular Control in Major Hepatic Resections -- Introduction -- Anatomical Fundaments for Vascular Control in Liver Surgery -- Inflow-Outflow-Parenchyma -- Types of Vascular Control -- Portal Triad Clamping -- Total- and Selective Hepatic Vascular Exclusion -- Selective or Total Hepatic Vascular Exclusion Combined with Cold Perfusion -- Infrahepatic Inferior Vena Cava Clamping -- Anesthesiological- and Pharmacological Interventions -- Laparoscopic Surgery -- Conclusion/Summary -- References -- 13: Two-Stage Liver Surgery -- Introduction and Development of TSH -- Indication of TSH for CLM -- Concomitant Extrahepatic Disease -- Surgical Procedures of TSH -- First-Stage Hepatectomy -- Portal Vein Ligation/Embolization -- Second-Stage Hepatectomy -- Concomitant Use of Local Ablation Therapy -- Primary Tumor Resection in Case of Synchronous Presentation -- Chemotherapy -- Preoperative Chemotherapy -- Interval Chemotherapy -- Postoperative Chemotherapy -- Drawbacks of TSH -- Short-Term Outcome -- Long-Term Outcome -- Prognostic Factors of Survival After TSH
Content:
Future Perspective of TSH -- References -- 14: Two-Stage Liver Surgery with Portal Vein Occlusion -- The Evolution of Staged Liver Surgery -- Indications and Limitations -- The Three Elements of Two-Stage Hepatectomy -- Portal Vein Occlusion (PVO) -- Chemotherapy (Systemic, Intra-arterial) -- Surgery -- How Far Can We Go? Failing Liver Regeneration and Small-for-Size Syndrome -- Outlook -- References -- 15: Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) -- Introduction -- Patient Selection and Preoperative Evaluation -- Surgical Technique -- Classical Technique -- First Stage -- Second Stage -- Proposed Technical Variations -- Hypertrophic Efficacy -- Interval Management and Timing of Second Stage -- Short and Long-Term Outcomes -- Postoperative Complications -- Oncological Results -- Benefits, Drawbacks, and Future Perspectives -- References -- 16: Parenchymal-Sparing Liver Resections -- Introduction -- Surgical Principles of Parenchymal-Sparing Liver Resection -- Oncological Principles of Parenchymal Sparing Liver Resection -- Ultrasound Guidance to Parenchymal-Sparing Liver Resections -- Laparoscopic Liver Resection -- References -- 17: Combined Vascular Resections -- Introduction -- Portal Triad Resections -- Hepatic Vein Resections -- Vena Cava Resections -- References -- 18: Ex-Vivo Liver Surgery -- Introduction -- Patient Selection -- Operative Technique -- Reference -- 19: The Role of Laparoscopy in Advanced Liver Disease -- Introduction -- Staging -- Tumor Ablation -- Laparoscopic Liver Resections (LLRs) -- Surgical Technique -- Results -- References -- 20: Liver Transplantation for Unresectable Disease -- Introduction -- Liver Transplantation for Tumors: Historical Perspective -- Liver Transplantation for Nonresectable CLM in Norway: The SECA Study -- Further Developments -- Patient Selection
Content:
Can the Access to Liver Grafts to CLM Patients Be Improved?
Additional Edition:
9783319138954
Additional Edition:
Print version de Santibañes, Eduardo Extreme Hepatic Surgery and Other Strategies : Increasing Resectability in Colorectal Liver Metastases Cham : Springer International Publishing,c2017 9783319138954
Language:
English
URL:
Volltext
(lizenzpflichtig)
