Interní Med. 2004; 6(1): 21-23

Nové trendy v chirurgii jater - kombinované, etapové výkony

Vladislav Třeška1, Tomáš Skalický1, MUDr. Alan Sutnar1, Hynek Mírka2, MUDr. Milan Novák2, MUDr. František Šlauf2
1 Chirurgická klinika FN Plzeň
2 Radiodiagnostická klinika FN Plzeň

Keywords: liver tumors # combined, stage procedures.

Published: December 31, 2004  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Třeška V, Skalický T, Sutnar A, Mírka H, Novák M, Šlauf F. Nové trendy v chirurgii jater - kombinované, etapové výkony. Interní Med. 2004;6(1):21-23.

Jedinou radikální léčbou primárních a sekundárních nádorů jater je léčba chirurgická - resekce jater. Bohužel jen 15-20 % nemocných s nádory jater je v době jejich diagnózy operabilních. Cílem kombinovaných, etapových výkonů je zvýšit operabilitu nádorového procesu v játrech. Autoři popisují spektrum nových kombinovaných postupů zahrnujících embolizaci větve portální žíly, lokoregionální a systémovou chemoterapii, etapové resekce jater a ablační techniky. Na základě využití kombinovaných etapových postupů, kdy nemocný podstupuje v průměru dva až tři výkony, je možné zvýšit operabilitu primárních a sekundárních nádorů jater z původních 15-20% na 40-50 %.

The new trends in liver surgery - combined, staged procedures

The only radical treatment of primary and secondary liver tumors is the surgical treatment - liver resection. Hepatectomy can be applied only for 15-20% patients with liver tumors. The aim of combined, staged liver procedures is increasing of liver tumors resecability. The authors describe the spectrum of the new combined methods including portal vein embolisation, locoregional and systemic chemotherapy, staged liver resections and ablative techniques. Combined, staged liver procedures, when a patient undergoes two or three procedures in average, increase the operability of liver tumors from recent 15-20 % to 40-50 %.

Download citation

References

  1. Skalický T, Třeška V, Šnajdauf J, a kol. Sekundární tumory jater. Chirurgie jater, Maxdorf-Jessenius, Praha 2004: 86-110.
  2. Befeler AS, Di Bisceglie AM. Hepatocellular carcinoma: diagnosis and treatment. Gastroenterology, 2002; 122: 1609-1619. Go to original source... Go to PubMed...
  3. Jaeck D, Bachellier P, Nakano H, Oussoultzoglou E, Weber J Ch, Wolf P, Greget M. One or two-stage hepatectomy combined with portal vein embolization for initially nonresectable colorectal liver metastases. AJS, 2003; 185: 221-229. Go to original source... Go to PubMed...
  4. Třeška V. Technika jaterních resekcí. Rozhl Chir, 2003; 82: 397-402. Go to PubMed...
  5. Vyhnánek F, Denemark L, Ducháč V, Škrabalová D. Kde je indikována resekce jater u metastáz. Rozhl chir 2003, 82; 570-576. Go to PubMed...
  6. Ryska M. Metastázy kolorektálního karcinomu v játrech a možnosti multimodální terapie. Bull. HPB 2001; 9: 29-33.
  7. Seymour K, Charnley R M, Rose J D G, Baudouin C J, Manas D. Preoperative portal vein embolisation for primary and metastatic liver tumours: volume effects, efficacy, complications and short-term outcome. HPB 2002; 4: 21-28. Go to original source... Go to PubMed...
  8. Soyer P, Roche A, Elias D, Levesque M. Hepatic metastases from colorectal cancer: influence of hepatic volumetric analysis on surgical decision-making. Radiology 1992; 184: 695-697. Go to original source... Go to PubMed...
  9. Leydendecker JR, Gerald DD. Minimally invasive techniques for the treatment of liver tumors. Sem Liver Disease 2001; 21: 283-291. Go to original source... Go to PubMed...
  10. Bismuth H, Adam R, Levi F. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg 1996; 224: 509-520. Go to original source... Go to PubMed...
  11. Lygidakis NJ, Vlachos L, Raptis S. New frontiers in liver surgery: two-stage liver surgery for the management of advanced metastatic liver disease. Hepatogastroenterology 1999; 46: 2216-2228. Go to PubMed...
  12. Adam R, Laurent A, Azoulay D. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors. Ann Surg 2000; 232: 777-785. Go to original source... Go to PubMed...
  13. Shimada H, Tanaka K, Masui H, Nagano Y, Matsuo K, Kijima M, Ichikawa Y, Ike H, Ooki S, Togo S. Results of surgical treatment for multiple bi-lobar hepatic metastases from colorectal cancer. Langenbeck´s Archives Surgery 2004; 4: 86-94. Go to original source... Go to PubMed...
  14. Minagawa M, Makuuchi M, Torzilli G, Takayama T, Kawasaki S. Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer. Long-term results. Ann Surg 2002; 231: 487-499. Go to original source... Go to PubMed...
  15. Tanaka K, Shimada H, Togo S, Ota M, Yamaguchi S, Ike H. Is hepatic resection for multiple liver metastases from colorectal carcinoma acceptable treatment? Hepatogastroenterology 2001; 48: 803-807. Go to PubMed...




Internal Medicine for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.