Authors
Khanevich M.D.1, 2, Manikhas G.M.3, Denikin M.S.3
1 St. Petersburg State Pediatric Medical University, St. Petersburg
2 Russian Research Institute of Hematology and Transfusiology FMBA, St. Petersburg
3 The First St. Petersburg State Medical University named after Academician I.P. Pavlov, St. Petersburg
Abstract
Currently, the main radical surgery for hepatocellular cancer and extensive metastatic damage to one half of the liver is an extended hemihepatectomy. In which up to 70% of the liver volume is removed. However, the remaining volume of liver tissue may be functionally insufficient. Liver failure develops rapidly in these patients, which is the main cause of postoperative mortality. On the other hand, with a decrease in the volume of hemihepatectomy, the radicality of operations may suffer.
In order to prevent tumor recurrence during extended hemihepatectomy, we successfully used the method of intraoperative cryotherapy on the wound surface of the remaining part of the liver, which was used in 29 patients with hepatocellular carcinoma. In 9 patients, operations were performed without cryotherapy. It should be emphasized that in all 38 cases, during hemihepatectomy, it was not possible to move more than 15 mm away from the edge of the tumor. The analysis of long-term results showed that the use of cryotherapy significantly reduced the number of patients with tumor recurrence.
Keywords: liver cancer, extended hemihepatectomy, intraoperative cryotherapy.
References
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