Abstract
A case of a 15-year-old girl with a malignant extraadrenal pheochromocytoma situated between the inferior vena cava and the portal triad is described. Using ex vivo technique, the tumour was successfully resected on the bench, as a previous attempt to remove the tumour in situ had been abandoned. The surgical aspects and implications of ex vivo surgery are discussed, highlighting the increased operative risk, perioperative mortality, and poor long-term results in patients with malignant tumours.
This is a preview of subscription content, log in via an institution to check access.
References
Tekautz TM, Pratt CB, Jenkins JJ, Spuut SL (2003) Pediatric extradural paraganglioma. J Pediatr Surg 38(9):1317–1321
Whaley RK, Althausen AF, Daniels GH (1992) Extraadrenal pheochromocytoma. J Urol 147:1–10
Pringle JH (1908) Notes on the arrest of hepatic hemorrhage due to trauma. Ann Surg 48:541–549
Berney T, Mehta G, Morel P (1998) Total vascular exclusion of the liver for the resection of lesions in contact with the vena cava or the hepatic veins. Br J Surg 85:485–488
Lodge JP, Ammori BJ, Prasad KR, Bellamy MC (2000) Ex vivo and in situ resection of inferior vena cava with hepatectomy for colorectal metastases. Ann Surg 231(4):471–479
Hannoun L, Balladur P, Delva E, Panis Y, Camus Y, Honiger J, Levy E, Parc R (1991) “Ex situ–in vivo” surgery of the liver: a new technique in liver surgery. Principles and preliminary results (French). Gastroenterol Clin Biol 15(10):758–761
Pichlmayr R, Grosse H, Hauss J, Gubernatis G, Lamesch P, Bretschneider HJ (1990) Technique and preliminary results of extracorporeal liver surgery (bench procedure) and of surgery on the in situ perfused liver. Br J Surg 77(1):21–26
Forni E, Meriggi F (1995) Bench surgery and liver autotransplantation. Personal experience and technical considerations. G Chir 16(10):407–413
Stephen MS, Sheil AG, Thomson JF et al (1990) Aortic occlusion and vascular isolation allowing avascular hepatic resection. Arch Surg 125:482–485
Myyazaki M, Hiroshi H, Nakagawa K, Ambiru S, Shimizu H, Okuno A, Nukui Y, Yoshitomi H, Kusashio K, Furuya S, Nakajima N (1999) Aggressive surgical resection for hepatic metastases involving the inferior vena cava. Am J Surg 177:294–298
Pichlmayr R, Bretschneider HJ, Kirchner E, Ringe B, Lamesch P, Gubernatis G, Hauss J, Niehaus KJ, Kaukemuller J (1988) Ex situ operation on the liver. A new possibility in liver surgery (German). Langenbecks Arch Chir 373(2):122–126
Raab R, Schlitt HJ, Oldhafer KJ, Bornscheuer A, Lang H, Pichlmayr R (2000) Ex-vivo resection techniques in tissue-preserving surgery for liver malignancies. Langenbecks Arch Surg 385(3):179–184
Belghiti J, Dousset B, Sauvanet A, Lipinska E, Aschehoug J, Fekete F (1991) Preliminary results with “ex situ” surgery for hepatic tumours: an alternative between palliative treatment and liver transplantation? Gastroenterol Clin Biol 15(5):449–453 (French)
Vaillant JC, Borie DC, Hannoun L (1998) Hepatectomy with hypothermic perfusion of the liver. Hepatogastroenterology 45(20):381–388
Delriviere L, Hannoun L (1995) In situ and ex situ in vivo procedures for complex major liver resections requiring prolonged hepatic vascular exclusion in normal and diseased livers. J Am Coll Surg 181(3):272–276
Kalayoglu M, Solinger HW, Stratta RJ et al (1988) Extended preservation of the liver for clinical transplantation. Lancet 1:617–619
Grosse H, Pichlmayr R, Hausen B, Lubbe N, Kirchner E (1990) Anaesthetic problems in ex situ resection of the liver. Anaesthesia 45(9):726–731
Miller CM, Schwartz ME, Nishizaki T (1991) Combined hepatic and vena caval resection with autogenous caval graft replacement. Arch Surg 126:106–108
Hemming AW, Reed AI, Langham MR, Fujita S, van der Werf WJ, Howard RJ (2002) Hepatic vein reconstruction for resection of hepatic tumours. Ann Surg 235(6):850–858
Chui AK, Rao AR, Wong J, Mann D, Leung KF, Lau WY (2003) Ex situ ex vivo liver resection, partial liver autotransplantation for advanced hilar cholangiocarcinoma: a case report. Transplant Proc 35(1):402–403
Hemming AW, Cattral MS (1999) Ex vivo liver resection with replacement of the inferior vena cava and hepatic vein replacement by transposition of the portal vein. J Am Coll Surg 189(5):523–526
Yanaga K, Kishikawa K, Shimada M, Kakizoe S, Higashi H, Nishizaki T, Matsumata T, Kanematsu T, Sugimachi K (1993) Extracorporeal hepatic resection for previously unresectable neoplasms. Surgery 113:637–643
Oldhafer KJ, Lang H, Malago M, Testa G, Broelsch CE (2002) Ex situ resection and resection of the in situ perfused liver: are there still indications? Chirurg 72(2):131–137 (German)
Oldhafer KJ, Lang H, Schlitt HJ, Hauss J, Raab R, Klempnauer J, Pichlmayr R (2000) Long-term experience after ex situ liver surgery. Surgery 127(5):520–527
Ein SH, Weitzman S, Thorner P (1994) Pediatric malignant pheochromocytoma. J Pediatr Surg 29:1197
Millar AJ, Hartley P, Khan D, Spearman W, Andronikou S, Rode H (2001) Extended hepatic resection with transplantation back up for an “unresectable” tumour. Pediatr Surg Int 17(5–6):378–381
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fusai, G., Steinberg, R., Prachalias, A. et al. Ex vivo liver surgery for extraadrenal pheochromocytoma. Ped Surgery Int 22, 282–285 (2006). https://doi.org/10.1007/s00383-005-1413-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-005-1413-x