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Hepatic Colorectal Metastases Involving Infra-Hepatic Inferior Vena Cava in High Risk Patients for Extended Resection: An Alternative Method for Achieving Radical Resection in Patient with Borderline Liver Remnant

  • Surgical Techniques and Innovations
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Abstract

Resection is the only chance of cure for isolated liver metastases from colorectal cancer. In the case of extended parenchymal resections, one crucial point is the ischemic damage to the remnant liver. We report an alternative technique for extremely extended liver resections without total hilar clamping for borderline liver remnants. Two patients presented with invasion of the infrahepatic vena cava, both with an estimated live remnant ≤20 %. The crucial point of the technique is the absence of a portal triad clamping in under beating heart-extracorporeal circulation. In both patients resection margins were free of disease. No signs of liver insufficiency were noted. Survival was more than 2 years in both cases. We believe that aggressive treatment of liver colorectal metastases should be given to all suitable patients. This operation may be added to the techniques that can be offered to these patients.

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Authors and Affiliations

  1. Department of medical and surgical emergencies, Dolo Hospital, Viale XXIX Aprile 26, 30031, Dolo, Venice, Italy

    Francesco Polistina

  2. General Surgery department, San Bortolo Hospital, 36100, Vicenza, Italy

    Francesco Polistina & Giovanni Ambrosino

  3. Department Cardiovascular Surgery, San Bortolo Hospital, 36100, Vicenza, Italy

    Alessandro Fabbri

  4. School of General Surgery, University of Padua, 35128, Padua, Italy

    Giovanni Ambrosino

Authors
  1. Francesco Polistina
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  2. Alessandro Fabbri
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  3. Giovanni Ambrosino
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Correspondence to Francesco Polistina.

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Polistina, F., Fabbri, A. & Ambrosino, G. Hepatic Colorectal Metastases Involving Infra-Hepatic Inferior Vena Cava in High Risk Patients for Extended Resection: An Alternative Method for Achieving Radical Resection in Patient with Borderline Liver Remnant. Indian J Surg 75, 220–225 (2013). https://doi.org/10.1007/s12262-012-0681-7

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  • DOI: https://doi.org/10.1007/s12262-012-0681-7

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