• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.266-272
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• 2005

Purpose: Recurrence occurs in various forms and in different organs after a curative resection of gastric cancer. The most common location for hematogenous recurrence is the liver. The aim of this study was to evaluate the clinicopathological risk factors associated with hepatic recurrence after surgical treatment of gastric cancer. Materials and Methods: We reviewed the medical records of 838 patients who had taken radical surgery for primary gastric cancers at Chonbuk National University Hospital between January 1992 and December 1999. According to the medical records, we retrospectively investigated the association between the clinicopathologic variables and hepatic recurence. Results: Recurrence of gastric cancer was documented in 201 out of the 838 patients (23.98%). Hepatic recurrences were found in 59 out of 201 patients (29.35%). Multiple logistic regression analysis identified the following as independent risk factors of hepatic recurrence: Lauren's Intestinal type (OR, 6.60; 95% Cl, 1.53 to 28.9; p=0.011) and proximal resection of margin below 6 cm (OR, 3.76; 95% Cl, 1.03 to 13.67; P=0.045). Conclusion: Various studies on clinocopathologic risk factors of liver recurrence with molecular biologic research should make possible the prediction of recurrence and help high-risk patients to find appropriate management.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.12-18
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• 2003

The purpose of this study is to evaluate children who underwent hepatic resection for primary malignant hepatic tumor in the period from January 1994 to December 2001. A total of 8 patients, seven with hepatoblastoma (HB) and one with hepatocellular carcinoma (HCC), were studied. One HCC was resectable at the initial diagnosis, but five cases of unresectable HB received two cycles of transarterial chemoembolization (TACE) before operation. One patient with an unresectable HB with bone marrow metastasis was operated after one cycle of TACE and one cycle of systemic chemotherapy based on CCG-823F protocol. Another unresectable HB patient received systemic chemotherapy instead of TACE before operation. Postoperative chemotherapy was administered to all of the patients after complete surgical resection on CCG-823F protocol. All 6 patients who underwent TACE and neoadjuvant chemotherapy showed marked reduction in tumor volume and a clear outline of the lesion. Major complication was not noticed. Mean alpha-fetoprotein (${\alpha}$-FP) level at diagnosis, after neoadjuvant chemotherapy and after postoperative chemotherapy was 9,818 (42-35,350), 664, and 10.1 ng/mL, respectively. Half life of the ${\alpha}$-FP after complete resection was 5.1 days (3.0-8.7 days). Median follow up period was 57.1 months (10-97 months) and all the patients are alive with NED. In conclusion, preoperative chemotherapy, especially TACE, is effective, safe, and useful to treat initially unresectable hepatoblastoma, and serial level of the serum ${\alpha}$-FP is a useful tumor marker for diagnosis and monitoring therapeutic responses.

• Journal of Korea Multimedia Society
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• v.13 no.3
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• pp.430-437
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• 2010

It is essential for living donor liver transplantation that surgeon must understand the hepatic vessel structure to improve the success rate of operation. In this paper, we extract the liver boundary without other surrounding structures such as heart, stomach, and spleen using the contrast enhanced MDCT liver image sequence. After that, we extract the major hepatic veins (left, middle, right hepatic vein) with morphological filter after review the basic structure of hepatic vessel which reside in segmented liver image region. The purpose of this study is provide the overall status of transplantation operation with size estimation of resection part which is dissected along with the middle hepatic vein. The method of liver extraction is as follows: firstly, we get rid of background and muscle layer with gray level distribution ratio from sampling process. secondly, the coincident images match with unit mesh image are unified with resulted image using the corse coordinate of liver and body. thirdly, we extract the final liver image after expanding and region filling. Using the segmented liver images, we extract the hepatic vessels with morphological filter and reversed the major hepatic vessels only with a results of ascending order of vessel size. The 3D reconstructed views of hepatic vessel are generated after applying the interpolation to provide the smooth view. These 3D view are used to estimate the dissection line after identify the middle hepatic vein. Finally, the volume of resection region is calculated and we can identify the possibility of successful transplantation operation.

• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.113-121
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• 2016

Background: We evaluated technique of hepatic resections using suprahilar-extrafascial dissection of Glissonean pedicle with vascular stapling device for pedicle transection with intent to minimize operative time and blood loss. Methods: We analyzed the clinical records of 326 patients who underwent anatomic liver resection by suprahilar-extrafascial pedicle isolation with vascular stapling division technique. Results: The minor liver resections were associated with significantly shorter surgery duration (105.1±21.1 vs. 225.6±75.6) and transection time (40.1±14.5 vs. 96.3±55.2) than major hepatectomies (p<0.0001 for all). The mean blood loss was 350.8±100.5 mL in minor resection and 485.4±250.2 mL in major resection (p=0.001). The mean blood transfusion requirement was 400.8±109.5 mL for minor resections and 550.9±100.0 mL for major hepatectomy (p=0.072). There was no significant difference in morbidity and mortality between groups (p=0.980; p=0.945). Major as well as minor liver resection were oncology superior with no significant difference in the 5-year overall survival rates. Conclusion: Suprahilar-extrafascial dissection of Glissonean pedicle represents an effective and safe technique of liver resection. Presented approach allows early and easy ischemic delineation of appropriate liver territory to be removed with selective inflow vascular control. It is not time consuming and it is very useful in re-resection, as well as oncological reasonable.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.125-132
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• 2022

Backgrounds/Aims: It is generally accepted that non-anatomical resection (NAR) in colorectal liver metastasis (CRLM) has comparable safety and efficacy compared to anatomical resection (AR); however, there are reports that AR may have better outcomes in KRAS mutated CRLM. This study aimed to determine the effects of KRAS mutations and surgical techniques on survival outcomes in CRLM patients. Methods: Two hundred fifty patients who underwent hepatic resection of CRLM with known KRAS mutational status between 2007 and 2018 were analyzed. A total of 94 KRAS mutated CRLM and 156 KRAS wild-type CRLM were subdivided by surgical approach and compared for short- and long-term outcomes. Results: In both KRAS wild-type and mutated type, there was no difference in estimated blood loss, postoperative complications, and 30-day mortality. There was no difference in disease-free survival (DFS) between AR and NAR in both groups (p = 0.326, p = 0.954, respectively). Finally, there was no difference in intrahepatic DFS between AR and NAR groups in both the KRAS groups (p = 0.165, p = 0.516, respectively). Conclusions: The presence of KRAS mutation may not be a significant factor when deciding the approach in simultaneous resection of CRLM.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.3
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• pp.257-262
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• 2022

Backgrounds/Aims: Middle hepatic vein (MHV) is usually preserved as a part of the right or left hepatectomy in order preserve the venous outflow of remnant liver. The aim of this study was to evaluate if resection of MHV could influence post-resection outcomes of standard right or left hepatectomy. Methods: Patients who underwent standard right or left hepatectomy between January 2015 and December 2019 were included. Anatomical remnant liver volumes were measured retrospectively using the Hermes workstation (Hermes Medical Solutions AB, Stockholm, Sweden). Uni- and multi-variate analyses were performed to assess the difference in outcomes of those with preservation of MHV and those without preservation. Results: A total of 144 patients were included. Right hepatectomy was performed for 114 (79.2%) and left hepatectomy was performed for 30 (20.8%) patients. MHV was resected for 13 (9.0%) in addition to the standard right or left hepatectomy. Median remnant liver volume was significantly higher in the MHV resected group (p < 0.01). There was no significant difference in serum level of bilirubin, international normalized ratio, alanine aminotransferase, creatinine on postoperative day 1, 3, 5, or 10, ≥ grade IIIa complications (p = 0.44), or 90-day mortality (p = 0.41). On multivariable analysis, resection of the MHV did not influence the incidence of post hepatectomy liver failure (p = 0.52). Conclusions: Resection of the MHV at standard right or left hepatectomy did not have a negative impact on postoperative outcomes of patients with adequate remnant liver volume.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.10-13
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• 2009

The prognosis of gastric cancer with hepatic metastasis is very poor, even though several treatment modalities exist, such as surgical resection. Indeed, a standard therapy has not been established in such patients. Recently, attempts were made to treat hepatic metastasis of gastric cancer with radiofrequency (RF), which was originally used in primary or metastatic liver cancer. RF has been reported to show similar survival compared to surgical resection and is emerging as a new treatment modality even though it is still not conclusive with respect to efficacy and safety due to the paucity of reports. A prospective study is warranted to evaluate the efficacy of RF in the treatment of gastric cancer with hepatic metastasis compared with conventional modalities.

• Journal of Chest Surgery
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• v.36 no.8
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• pp.623-626
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• 2003

Desmoid tumors are benign neoplasms with high rates of recurrence. A case of huge desmoid tumor of the intrathoracic and intraabdominal space is presented. The patient was treated with resection, which involved hepatic left lobectomy and diaphragmatic resection and partial pericardiectorny and wedge resection of left lower lobe of lung. The resulting defect over the pericarium and diaphragm was reconstructed by bovine pericardium and Marlex mesh. Prevention of presumed local recurrence of desmoid tumors requires wide excision margin.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.360-365
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• 2022

A 15-year-old spayed female Yorkshire Terrier was presented to our hospital with a history of anorexia, depression and abdominal pain. Diagnostic procedures including blood test, radiography and ultrasonography were performed. Abdominal ultrasonography revealed multiple hypoechoic cysts in the left lobe of the liver. Over time, the cysts increased in size and became more echogenic. Four days later, the rupture of the largest cyst was suspected, and hepatic abscesses with bacteria were confirmed by aspiration of the cyst. Despite surgical resection of the abscessed liver lobe, antibiotic administration, and supportive therapy, the dog died 9 days after presentation to the hospital and 4 days after the surgical procedure. The present case report described the overall diagnostic and therapeutic approaches for liver abscesses in a dog.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.648-654
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• 1989

A clinical study was performed on 363 cases of pulmonary tuberculosis treated surgically resection during the period of 3 years from January, 1986 to December, 1988 in the National Kong-Ju Hospital. The results obtained are follows: 1. The ratio of male to female was 1.6:1 in male predominance, age from 20 to 40 occurred 82.6% of the total cases. 2. The moderately advanced cases was the highest incidence with 53.2 % for extent of disease, duration of illness which 1 to 5 years before operation was 40.8 % of the total cases. 3. Preoperative sputum examination for AFB was 53.2 % in negative but in spite of chemotherapy, persistent positive sputum was 46.7%. 4. Indication for surgery were: total destroyed lung was 35.5 %, destroyed lobe or segment with or without cavity was 30.6%, empyema with or without bronchopleural fistula was 8.5%, according to type and site of surgical procedure, pleuropneumonectomy and pneumonectomy was the highest incidence with 53.4 %, left site was slightly more than right with 55.9 % of the total cases. 5. The incidence of postoperative complication was 10.2 % and then the highest incidence was empyema with or without bronchopleural fistula with 4%, according to type of surgical procedure, postpleuropneumonectomy and postpneumonectomy was 6.1 % of the total cases. 6. Postoperative mortality was 1.4 % of the total cases, according to cause of deaths, hypovolemic shock due to bleeding were 2 cases, respiratory failure were 2 cases and hepatic coma due to hepatic failure was 1 case.