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Ultrasound-Guided Conservative Heopatecomy for Tumors Invading the Middle Hepatic Vein at the Caval Confluence as Alternative to Mesohepatectomy and Trisectionectomy


N/A
N/A
N/A
Not Enrolling
Both
Colorectal Liver Metastases, Hepatocellular Carcinoma

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Trial Information

Ultrasound-Guided Conservative Heopatecomy for Tumors Invading the Middle Hepatic Vein at the Caval Confluence as Alternative to Mesohepatectomy and Trisectionectomy


Major hepatectomies have not negligible morbidity and mortality. However, when tumors invade
middle hepatic vein (MHV) at caval confluence trisectionectomy (TS) is generally performed,
and central hepatectomy or mesohepatectomy (MH) (Segments 4, 5 and 8), is considered by
some authors to be the conservative alternative to the previously cited approach. Between
these two surgical interventions there is not, up to now, any evidence that one of them
should be clearly preferred; anyway both are mojor resections. We previously reported that a
surgical approach based on ultrasound-guided hepatectomy might minimize the need for major
resection, whose rates of morbidity and mortality are not negligible. This policy could be
useful also for disclosing new, more conservative, and better tolerated approaches for
tumors invading the MHV at caval confluence in alternative to MH and TS. This study
analyses the feasibility, safety and effectiveness of ultrasound-guided resections applied
to these patients enrolled prospectively from a cohort of consecutive patients who undergo
hepatectomy for tumors.


Inclusion Criteria:



- Patients carriers of HCC or colorectal cancer liver metastases (CLM) who have
macroscopic signs of vascular invasion (preoperative imaging and/IOUS) of the MHV
close to the hepato-caval confluence (within 4 cm) demanding for that MHV resection.

Minimum follow-up for patients' inclusion was established at 6-months from surgery.

Exclusion Criteria:

- Patients carriers of tumors occupying entirely the right paramedian section and the
segment 4, for whom at least a MH would have been compulsorily carried out.

Type of Study:

Observational

Study Design:

Observational Model: Cohort, Time Perspective: Prospective

Outcome Measure:

The primary outcome measure was the rate of failure of conservative resection, i.e. the rate of patients who received TSs or MHs despite they fitted in the eligibility criteria.

Outcome Time Frame:

January 2007

Safety Issue:

No

Principal Investigator

Guido Torzilli, MD, PhD

Investigator Role:

Principal Investigator

Investigator Affiliation:

University of Milan, Istituto Clinico Humanitas - IRCCS

Authority:

Italy: Ministry of Health

Study ID:

HEP-MHV

NCT ID:

NCT00600522

Start Date:

January 2004

Completion Date:

May 2007

Related Keywords:

  • Colorectal Liver Metastases
  • Hepatocellular Carcinoma
  • intraoperative ultrasonography
  • hepatectomy
  • colorectal liver metastases
  • hepatocellular carcinoma
  • contrast enhanced intraoperative ultrasonography.
  • Carcinoma
  • Neoplasm Metastasis
  • Liver Neoplasms
  • Carcinoma, Hepatocellular

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