Assuntos
Angiografia/métodos , Laparotomia/métodos , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias Retroperitoneais/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/cirurgiaRESUMO
The development of postoperative ventral hernia was observed in 8 patients from 114, who undergone the liver transplantation operation. The patients were followed in terms up to 14.5 years. The authors consider the indications and features of surgical treatment of such postoperative hernias.
Assuntos
Hérnia Ventral/cirurgia , Herniorrafia/métodos , Transplante de Fígado/efeitos adversos , Telas Cirúrgicas , Feminino , Seguimentos , Hepatite C Crônica/cirurgia , Hérnia Ventral/etiologia , Humanos , Pessoa de Meia-Idade , Complicações Pós-OperatóriasRESUMO
The authors made an analysis of their first 100 transplantations of cadaveric liver made at the period from 1998 through 2011. Postoperative complications and long-term results of transplantations at the period to 13 years are described. Cumulative survival up to 12 months was 91%, to 36 months--83%. Retransplantation of the liver was performed on 5 patients, 2 of them being successful.
Assuntos
Doença Hepática Terminal/cirurgia , Transplante de Fígado , Complicações Pós-Operatórias/prevenção & controle , Coleta de Tecidos e Órgãos , Adulto , Feminino , Humanos , Terapia de Imunossupressão/métodos , Estimativa de Kaplan-Meier , Transplante de Fígado/efeitos adversos , Transplante de Fígado/métodos , Transplante de Fígado/mortalidade , Masculino , Pessoa de Meia-Idade , Monitorização Imunológica , Seleção de Pacientes , Reoperação , Coleta de Tecidos e Órgãos/métodos , Coleta de Tecidos e Órgãos/tendências , Resultado do TratamentoAssuntos
Cateterismo/métodos , Ducto Colédoco , Constrição Patológica , Drenagem/métodos , Transplante de Fígado/efeitos adversos , Complicações Pós-Operatórias/cirurgia , Anastomose Cirúrgica/efeitos adversos , Anastomose Cirúrgica/métodos , Colangiografia , Ducto Colédoco/patologia , Ducto Colédoco/fisiopatologia , Ducto Colédoco/cirurgia , Constrição Patológica/etiologia , Constrição Patológica/fisiopatologia , Constrição Patológica/cirurgia , Feminino , Humanos , Cirrose Hepática/cirurgia , Transplante de Fígado/métodos , Stents , Resultado do Tratamento , Adulto JovemRESUMO
An analysis of results of 83 operations performed for tumors of the hepatopancreatobiliary zone included the period of 2006-2007. In 39 resections of the pancreas there were 16 (41.0%) cases when the operation was supplemented with a reconstruction of the major vessels. From 44 resections of the liver 10 (22.7%) interventions were made with resection of the major veins. No specific complications were noted associated with vascular reconstructions in the zones in question. Postoperative lethality after operations for malignant tumors of the hepatopancreatobiliary zone was 2.4%, after operations in the same zone supplemented with vascular reconstructions was 3.8%. The duration of postoperative hospital stay was practically the same of that of the patients operated for malignant tumors of the hepatopancreatobiliary zone without vascular reconstructions. One year survival of the patients operated for malignant tumors of the hepatopancreatobiliary zone without and with vascular reconstructions was commensurable. Reconstruction of the major vessels in operations for locally extensive tumors of the hepatopancreatobiliary zone allows more often using radical surgical interventions. Complete restoration of the patency of the major vessels in the zone of operations for tumor processes in the liver and pancreas alleviates the postoperative period, is not followed by more number of postoperative complications and lethality.
Assuntos
Neoplasias do Sistema Biliar/irrigação sanguínea , Neoplasias do Sistema Biliar/cirurgia , Neoplasias Hepáticas/irrigação sanguínea , Neoplasias Hepáticas/cirurgia , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Pancreáticas/cirurgia , Artérias/cirurgia , Neoplasias do Sistema Biliar/patologia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/patologia , Veias/cirurgiaRESUMO
The initial results are discussed of treatment protocol for unresectable liver tumors using combinations of cytoreductive surgery (resection and/or radiofrequency ablation (RFA)) and hepatic artery infusion pump (HAIP) placement to be followed by chemotherapy. Out of 14 patients with unresectable liver tumors (2003-2006), 12 were operated on for colorectal metastases, 1 - hepatocellular carcinoma, and 1 metastatic carcinoid. Seven patients received RFA, 4 - resection+RFA+ HAIP, and 3 - resection+ HAIP. All patients were given HAIP postoperatively. No grave complications were reported. Mean follow-up was 14 months (6-38) with an average of 6 chemotherapy cycles (2-12) per patient. At present, 8 patients have survived 6-38 months and continue to receive regional chemotherapy; overall 1- or 2- year survival is 85 and 57%, respectively. Six patients died from tumor progression within 4-21 months.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Ablação por Cateter , Artéria Hepática , Bombas de Infusão Implantáveis , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Progressão da Doença , Feminino , Humanos , Infusões Intra-Arteriais , Masculino , Estudos Retrospectivos , Análise de Sobrevida , Resultado do TratamentoRESUMO
The data on the treatment of colorectal carcinoma and synchronous metastatic involvement of the liver in 41 patients are presented. After extensive resections, complications were reported in 45.5%, partial--12%. Post-operative mortality was 4.9%. Relapse-free survival in group 1 was 8.9 +/- 2.7 months, group 2-9.7 +/- 3.1 months. Hepatic tumor progression within 3.5-39 months (9.1 +/- 2.4 months) was registered in 73.2%. Average survival in patients who had single-stage surgery was 23.1 months, after metachronous operations--23.7 months. Five-year survival rate was 12.1%.
Assuntos
Colectomia/métodos , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Hepatectomia/métodos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Adulto , Idoso , Colectomia/efeitos adversos , Neoplasias Colorretais/mortalidade , Progressão da Doença , Intervalo Livre de Doença , Feminino , Hepatectomia/efeitos adversos , Humanos , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/mortalidade , Análise de Sobrevida , Resultado do TratamentoRESUMO
The purpose of the study was to evaluate the results of combined (hepatic artery and portal vein) oily chemoembolization (OCE) in patients with unresectable colorectal liver metastases. Courses of combined OCE were given to 45 patients (1990-2000). For arterial OCE (n = 150), 40-100 mg doxorubicin mixed with 10-15 ml iodized oil and gelatin sponge was used. OCE of the portal vein (n = 118) included injection of doxorubicin-in-oil without sponge. Response to treatment (partial tumor decrease or stabilization) was reported in 80%. Serious complications occurred in 3 patients (7%) but there was no mortality. The mean and median survival rates for those patients who died were 20.2 and 17 months, respectively. The 1-, 2-, and 3-year survival rates were 83, 40 and 14%, respectively. These results were significantly better than those for arterial OCE alone or hepatic arterial infusion. Combined (arterial and portal vein) OCE with doxorubicin appears the most effective locoregional treatment for unresectable colorectal liver metastases.