RESUMO
The results of surgical treatment of 316 patients, suffering focal hepatic diseases, in whom for preoperative preparation a portal vein embolization (PVE) was performed, were analyzed. PVE was applied in a small planned hepatic residual volume. The patients have aged from 21 to 77 yrs, (57 ± 10.6) yrs at average. During (22 ± 7) days after the procedure a hypertrophy of a planned postresectional hepatic volume by 58.6% was observed, while a hypertrophy degree have depended on the embolization volume performed: 57.3%--after embolization of branches of C(V)-C(VIII) hepatic segments, 66%--the segments C(V)-C(VIII) + C(IV). In 281 (89%) patients the extensive hepatic resection was performed, a fatal postresection hepatic insufficiency was not observed. A three-year and five-year disease-free survival have constituted 43.8 and 16.4% accordingly. Thus, a PVE constitutes a miniinvasive intervention, permitting to achieve a planned residual hepatic volume, to expand a diapazon of application of radical extensive hepatic resection in patients, suffering focal hepatic diseases while a small planned residual hepatic volume.
Assuntos
Embolização Terapêutica/métodos , Hepatectomia/métodos , Insuficiência Hepática/cirurgia , Fígado/cirurgia , Veia Porta/cirurgia , Adulto , Idoso , Intervalo Livre de Doença , Embolização Terapêutica/mortalidade , Feminino , Insuficiência Hepática/diagnóstico por imagem , Insuficiência Hepática/mortalidade , Insuficiência Hepática/patologia , Humanos , Fígado/irrigação sanguínea , Fígado/diagnóstico por imagem , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Veia Porta/patologia , Cuidados Pré-Operatórios , RadiografiaRESUMO
The changes in intrahepatic blood flow, occuring after embolization of right branch (ERB) of portal vein (PV) in 42 patients, to whom a major hepatic resection was planned for focal hepatic diseases, were analyzed. Together with cessation of blood flow along the PV embolized branch, there was noted the enhancement of the volume blood flow along the PV left branch by 226% on the third day after embolization with its subsequent enhancement by 337% comparing with initial one. Enhancement of a volume blood flow along right hepatic artery (HA) by 282% was noted on the third day after ERB PV with subsequent nonsignificant reduction, and a blood flow along the left hepatic artery branch did not change essentially. The blood flow enhancement in left hepatic lobe have promoted her regeneration and increase of volume of the organ residual planned.
