Safety and efficacy of hepatic vein reconstruction for colorectal liver metastases

Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake Hospital, Koto-ku, Tokyo, Japan.
American journal of surgery (Impact Factor: 2.29). 07/2011; 202(4):449-54. DOI: 10.1016/j.amjsurg.2010.08.040
Source: PubMed


Colorectal liver metastases with hepatic vein (HV) involvement may require combined resection of the liver and HV. However, the short- and long-term outcomes of such a procedure remain unclear.
We reviewed 16 cases of liver resection with major HV resection and reconstruction.
The patients had a median age of 58.5 years (range, 50-74 y). In total, 18 HVs were reconstructed using a customized great saphenous vein graft (n = 10), direct anastomosis (n = 1), external iliac vein (n = 2), portal vein (n = 1), umbilical vein patch graft (n = 3), or ovarian vein patch graft (n = 1). There was no hospital mortality, and the morbidity rate was 50%. With a median follow-up period of 30 months (range, 4-89 mo), 3 patients died of tumor recurrence and 13 were alive with (n = 6) and without (n = 7) disease. Cumulative 1-, 3-, and 5-year survival rates were 93%, 76%, and 76%, respectively.
HV resection and reconstruction combined with liver resection can be performed safely with reasonable long-term results.

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