Improvement of surgical margin with a coupled saline-radio-frequency device for multiple colorectal liver metastases
- 52 Downloads
Complete resection of colorectal liver metastases (LM) has been the only curative treatment. However, when LM are multiple and bilobar, only a few patients are candidates for curative surgery. We report on a 53-year-old woman with synchronous multiple and bilobar LM from sigmoidal cancer who became resectable after a multimodal strategy including preoperative systemic chemotherapy and two-step surgery. The spectacular decrease in tumor size after systemic chemotherapy led us to perform two-step surgery, including right portal-vein ligation and left liver metastasectomies, with a coupled saline-radiofrequency device, in order to improve the surgical margin. An extended right hepatectomy was performed later to remove the remaining right liver lesions. The patient was discharged after 28 days without major complication and was recurrence-free 14 months later. We conclude that improving the surgical margin with a coupled saline-radiofrequency device is feasible and effective, avoiding small remnant liver even after multiple tumorectomies. The multimodal strategy, including preoperative chemotherapy, two-step surgery, and tumorectomies, using a coupled saline-radiofrequency device, could increase the number of patients with diffuse bilobar liver metastases who can benefit from liver resection.
Key wordsDiffuse bilobar liver metastases Systemic chemotherapy Portal vein ligation Coupled saline-radiofrequency device Two-step surgery
Unable to display preview. Download preview PDF.
- 7.Kianmanesh, R, Farges, O, Abdalla, EK, Sauvanet, A, Ruszniewski, P, Belghiti, J 2003Right portal vein ligation: a new planned two-step all-surgical approach for complete resection of primary gastrointestinal tumors with multiple bilateral liver metastasesJ Am Coll Surg19716470PubMedCrossRefGoogle Scholar
- 10.Pearson, M, McClurken, M, Thompson, R 2002Saline enhanced thermal sealing of tissue: potential for bloodless surgeryMin Invas Ther Allied Technol1126570Google Scholar