Hepatic Vein-sparing Hepatectomy for Colorectal Liver Metastases at the Caval Confluence

University of Milan50 enrolled

Overview

Major hepatectomies are generally selected for tumors involving the hepatic vein (HV) at the caval confluence (CC). As alternative, HV reconstruction has been proposed. The present study aimed to evaluate the feasibility and safety of a HV-sparing policy guided by intraoperative ultrasonography (IOUS) in a cohort of patients having at least one colorectal liver metastasis (CLM) in contact with a HV at CC. HV section can be avoided in the large majority of cases thanking to CLMs detachment or to HV partial resection or reconstruction: this policy seems feasible, safe, reduces the need of major hepatectomies, and oncologically provides an adequate local control.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Secondary Malignant Neoplasm of Liver

Interventions

Hepatic vein-sparing hepatectomyPROCEDURE

HV detachment, partial resection and section on the basis of HV-CLM relationship

Eligibility

Sex: ALLMin age: 28 YearsMax age: 79 Years

Medical Language ↔ Plain English

Inclusion Criteria: * diagnosis of at least one CLM in contact with HV at caval confluence and HV patency at preoperative imaging * at least 6 months of follow-up after surgery Exclusion Criteria: * suspected or ascertained thrombosis or full tumoral involvement of HV at preoperative imaging * portal pedicle infiltration and/or thrombosis * unresectability at laparotomy for any extra-hepatic or intrahepatic reason not related to tumor-vessel relations

Locations (1)

Department of Hepatobiliary and General Surgery, Humanitas Research Hospital, University of Milan

Rozzano, Milan, Italy

Outcomes

Primary Outcomes

the safety of HV-sparing surgery in terms of operative mortality and morbidity

Time frame: within 30-90 days after surgery

Data from ClinicalTrials.gov

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