Preview

Анналы хирургической гепатологии

Расширенный поиск

Современные тенденции в хирургии печени

https://doi.org/10.16931/1995-5464.2022-4-15-22

Аннотация

Хирургия печени на протяжении всей своей истории постоянно претерпевает значительные изменения и во многом зависит от научных и технологических достижений. В настоящее время резекция печени позволяет надеяться на излечение пациента. Реализуются такие новые тенденции в хирургии печени, как сберегающие паренхиму операции, доведение до минимума отступа от опухоли, скелетизация сосудов. Внедряют принцип резекции вдоль печеночных вен с максимальной детализацией ориентиров. Это позволяет хирургам расширять свои возможности, охватывая новые когорты пациентов с множественными опухолями, ранее считавшимися нерезектабельными. Происходит улучшение непосредственных результатов без негативного влияния на отдаленные результаты операций.

Об авторах

Г. Г. Ахаладзе
ФГБУ “Российский научный центр рентгенорадиологии” Минздрава России
Россия

Ахаладзе Гурам Германович – доктор мед. наук, профессор, главный научный сотрудник научно-исследовательского отдела хирургии и хирургических технологий в онкологии 

117997, ГПС-7, Москва, ул. Профсоюзная, д. 86



О. А. Иванова
ФГБУ “Российский научный центр рентгенорадиологии” Минздрава России
Россия

Иванова Ольга Александровна – аспирант отделения абдоминальной онкологии

117997, ГПС-7, Москва, ул. Профсоюзная, д. 86

Тел.: 8-922-866-31-19 



Список литературы

1. Torzilli G., Procopio F., Fabbro D. Ultrasound-Guided Liver Surgery. 1st ed. Milan: Springer, 2014. 280 p.

2. Gotohda N., Cherqui D., Geller D.A., Abu Hilal M., Berardi G., Ciria R., Abe Y., Aoki T., Asbun H.J., Chan A.C.Y., Chanwat R., Chen K.H., Chen Y., Cheung T.T., Fuks D., Han H.S., Hasegawa K., Hatano E., Honda G., Itano O., Iwashita Y., Kaneko H., Kato Y., Kim J.H., Liu R., López-Ben S., Morimoto M., Monden K., Rotellar F., Sakamoto Y., Sugioka A., Yoshiizumi T., Akahoshi K., Alconchel F., Ariizumi S., Benedetti Cacciaguerra A., Durán M., Garcia Vazquez A., Golse N., Miyasaka Y., Mori Y., Ogiso S., Shirata C., Tomassini F., Urade T., Wakabayashi T., Nishino H., Hibi T., Kokudo N., Ohtsuka M., Ban D., Nagakawa Y., Ohtsuka T., Tanabe M., Nakamura M., Yamamoto M., Tsuchida A., Wakabayashi G. Expert Consensus Guidelines: How to safely perform minimally invasive anatomic liver resection.J. Hepatobiliary. Pancreat. Sci. 2022; 29 (1): 16–32. https://doi.org/10.1002/JHBP.1079

3. Adam R., Kitano Y. Multidisciplinary approach of liver metastases from colorectal cancer. Ann. Gastroenterol. Surg. 2019; 3 (1): 50. https://doi.org/10.1002/AGS3.12227

4. Protic M., Krsmanovic O., Solajic N., Kukic B., Nikolic I., Bogdanovic B., Radovanovic Z., Kresoja M., Mannion C., Man Y.G., Stojadinovic A. Prospective non-randomized study of intraoperative assessment of surgical resection margin of colorectal liver metastases. J. Cancer. 2021; 12 (12): 3701. https://doi.org/10.7150/JCA.58580

5. Xu F., Tang B., Jin T.Q., Dai C.L. Current status of surgical treatment of colorectal liver metastases. World J. Clin. Cases. 2018; 6 (14): 716–734. https://doi.org/10.12998/WJCC.V6.I14.716

6. Solaini L., Gardini A., Passardi A., Mirarchi M., D’Acapito F., la Barba G., Cucchi M., Casadei Gardini A., Frassineti G., Cucchetti A., Ercolani G. Preoperative chemotherapy and resection margin status in colorectal liver metastasis patients: a propensity score-matched analysis. Am. Surg. 2019; 85 (5): 488–493.

7. Holm A., Bradley E., Aldrete J.S. Hepatic resection of metastasis from colorectal carcinoma. Morbidity, mortality, and pattern of recurrence. Ann. Surg. 1989; 209 (4): 428–434. https://doi.org/10.1097/00000658-198904000-00007

8. Ekberg H., Tranberg K.G., Andersson R., Lundstedt C., Hägerstrand I., Ranstam J., Bengmark S. Determinants of survival in liver resection for colorectal secondaries. Br. J. Surg. 1986; 73 (9): 727–731. https://doi.org/10.1002/BJS.1800730917

9. Kokudo N., Miki Y., Sugai S., Yanagisawa A., Kato Y., Sakamoto Y., Yamamoto J., Yamaguchi T., Muto T., Makuuchi M. Genetic and histological assessment of surgical margins in resected liver metastases from colorectal carcinoma: minimum surgical margins for successful resection. Arch. Surg. 2002; 137 (7). https://doi.org/10.1001/ARCHSURG.137.7.833

10. Konopke R., Kersting S., Makowiec F., Gaßmann P., Kuhlisch E., Senninger N., Hopt U., Saeger H.D. Resection of colorectal liver metastases: is a resection margin of 3 mm enough? A multicenter analysis of the GAST Study Group. World J. Surg. 2008; 32 (9): 2047–2056. https://doi.org/10.1007/S00268-008-9629-2

11. de Haas R.J., Wicherts D.A., Flores E., Azoulay D., Castaing D., Adam R. R1 resection by necessity for colorectal liver metastases: is it still a contraindication to surgery? Ann. Surg. 2008; 248 (4): 626–636. https://doi.org/10.1097/SLA.0B013E31818A07F1

12. Pandanaboyana S., White A., Pathak S., Hidalgo E.L., Toogood G., Lodge J.P., Prasad K.R. Impact of margin status and neoadjuvant chemotherapy on survival, recurrence after liver resection for colorectal liver metastasis. Ann. Surg. Oncol. 2015; 22 (1): 173–179. https://doi.org/10.1245/S10434-014-3953-6

13. Andreou A., Aloia T.A., Brouquet A., Dickson P.V., Zimmitti G., Maru D.M., Kopetz S., Loyer E.M., Curley S.A., Abdalla E.K., Vauthey J.N. Margin status remains an important determinant of survival after surgical resection of colorectal liver metastases in the era of modern chemotherapy. Ann. Surg. 2013; 257 (6): 1079–1088. https://doi.org/10.1097/SLA.0B013E318283A4D1

14. Viganò L., Procopio F., Cimino M.M., Donadon M., Gatti A., Costa G., del Fabbro D., Torzilli G. Is tumor detachment from vascular structures equivalent to r0 resection in surgery for colorectal liver metastases? An observational cohort. Ann. Surg. Oncol. 2016; 23 (4): 1352–1360. https://doi.org/10.1245/ S10434-015-5009-Y

15. Oshi M., Margonis G.A., Sawada Y., Andreatos N., He J., Kumamoto T., Morioka D., Wolfgang C.L., Tanaka K., Weiss M.J., Endo I. Higher tumor burden neutralizes negative margin status in hepatectomy for colorectal cancer liver metastasis. Ann. Surg. Oncol. 2019; 26 (2): 593–603. https://doi.org/10.1245/S10434-018-6830-X

16. Sadot E., Koerkamp B.G., Leal J.N., Shia J., Gonen M., Allen P.J., DeMatteo R.P., Kingham T.P., Kemeny N., Blumgart L.H., Jarnagin W.R., D’Angelica M. Resection margin and survival in 2368 patients undergoing hepatic resection for metastatic colorectal cancer: surgical technique or biologic surrogate? Ann. Surg. 2015; 262 (3): 476–483. https://doi.org/10.1097/SLA.0000000000001427

17. Andreou A., Aloia T.A., Brouquet A., Dickson P.V., Zimmitti G., Maru D.M., Kopetz S., Loyer E.M., Curley S.A., Abdalla E.K., Vauthey J.N. Margin status remains an important determinant of survival after surgical resection of colorectal liver metastases in the era of modern chemotherapy. Ann. Surg. 2013; 257 (6): 1079–1088. https://doi.org/10.1097/SLA.0B013E318283A4D1

18. Paniccia A., Schulick R.D. Surgical margin in hepatic resections for colorectal metastasis: should we care? Curr. Colorectal Cancer Rep. 2016; 12 (3): 180–187. https://doi.org/10.1007/S11888-016-0323-8/TABLES/1

19. AyezN., Lalmahomed Z.S., Eggermont A.M.M., Ijzermans J.N.M., de Jonge J., van Montfort K., Verhoef C. Outcome of microscopic incomplete resection (R1) of colorectal liver metastases in the era of neoadjuvant chemotherapy. Ann. Surg. Oncol. 2012; 19 (5): 1618–1627. https://doi.org/10.1245/S10434-011-2114-4

20. Postriganova N., Kazaryan A.M., Røsok B.I., Fretland Å.A., Barkhatov L., Edwin B. Margin status after laparoscopic resection of colorectal liver metastases: does a narrow resection margin have an influence on survival and local recurrence? HPB (Oxford). 2014; 16 (9): 822–829. https://doi.org/10.1111/HPB.12204

21. Broering D.C., Hillert C., Krupski G., Fischer L., Mueller L., Achilles E.G., Schulte Am Esch J., Rogiers X. Portal vein embolization vs. portal vein ligation for induction of hypertrophy of the future liver remnant. J. Gastrointest. Surg. 2002; 6 (6): 905–913. https://doi.org/10.1016/S1091-255X(02)00122-1

22. Schnitzbauer A.A., Lang S.A., Goessmann H., Nadalin S., Baumgart J., Farkas S.A., Fichtner-Feigl S., Lorf T., Goralcyk A., Hörbelt R., Kroemer A., Loss M., Rümmele P., Scherer M.N., Padberg W., Königsrainer A., Lang H., Obed A., Schlitt H.J. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann. Surg. 2012; 255 (3): 405–414. https://doi.org/10.1097/SLA.0B013E31824856F5

23. Schadde E., Ardiles V., Robles-Campos R., Malago M., Machado M., Hernandez-Alejandro R., Soubrane O., Schnitzbauer A.A., Raptis D., Tschuor C., Petrowsky H., De Santibanes E., Clavien P.A. Early survival and safety of ALPPS: first report of the International ALPPS Registry. Ann. Surg. 2014; 260 (5): 829–838. https://doi.org/10.1097/SLA.0000000000000947

24. Chua T.C., Liauw W., Chu F., Morris D.L. Summary outcomes of two-stage resection for advanced colorectal liver metastases. J. Surg. Oncol. 2013; 107 (2): 211–216. https://doi.org/10.1002/JSO.23170

25. Linecker M., Stavrou G.A., Oldhafer K.J., Jenner R.M., Seifert B., Lurje G., Bednarsch J., Neumann U., Capobianco I., Nadalin S., Robles-Campos R., de Santibañes E., Malagó M., Lesurtel M., Clavien P.A., Petrowsky H. The ALPPS Risk Score: avoiding futile use of ALPPS. Ann. Surg. 2016; 264 (5): 763–771. https://doi.org/10.1097/SLA.0000000000001914

26. del Fabbro D., Galvanin J., Torzilli G. R1vasc surgery for colorectal liver metastases. Minerva Surg. 2022. https://doi.org/10.23736/S2724-5691.22.09355-8

27. Tanaka K., Shimada H., Matsumoto C., Matsuo K., Takeda K., Nagano Y., Togo S. Impact of the degree of liver resection on survival for patients with multiple liver metastases from colorectal cancer. World J. Surg. 2008; 32 (9): 2057–2069. https://doi.org/10.1007/S00268-008-9610-0

28. Umeda Y., Nagasaka T., Takagi K., Yoshida R., Yoshida K., Fuji T., Matsuda T., Yasui K., Kumano K., Sato H., Yagi T., Fujiwara T. Technique of vessel-skeletonized parenchymasparing hepatectomy for the oncological treatment of bilobar colorectal liver metastases. Langenbecks. Arch. Surg. 2022; 407 (2): 685–697. https://doi.org/10.1007/S00423-021-02373-9

29. Viganò L., Procopio F., Cimino M.M., Donadon M., Gatti A., Costa G., del Fabbro D., Torzilli G. Is tumor detachment from vascular structures equivalent to R0 resection in surgery for colorectal liver metastases? An observational cohort. Ann. Surg. Oncol. 2016; 23 (4): 1352–1360. https://doi.org/10.1245/S10434-015-5009-Y

30. Krausch M., Raffel A., Anlauf M., Schott M., Lehwald N., Krieg A., Topp S.A., Cupisti K., Knoefel W.T. “Cherry picking”, a multiple non-anatomic liver resection technique, as a promising option for diffuse liver metastases in patients with neuroendocrine tumours. World J. Surg. 2014; 38 (2): 392–401. https://doi.org/10.1007/S00268-013-2267-3

31. Yamamoto M., Ariizumi S.I. Glissonean pedicle approach in liver surgery. Ann. Gastroenterol. Surg. 2018; 2 (2): 124–128. https://doi.org/10.1002/AGS3.12062

32. Makuuchi M., Hasegawa H., Yamazaki S. Ultrasonically guided subsegmentectomy. Surg. Gynecol. Obstet. 1985; 161 (4): 346–350.

33. Nagino M., DeMatteo R., Lang H., Cherqui D., Malago M., Kawakatsu S., DeOliveira M.L., Adam R., Aldrighetti L., Boudjema K., Chapman W., Clary B., de Santibañes E., Dong J., Ebata T., Endo I., Geller D., Guglielmi A., Kato T., Lee S.G., Lodge P., Nadalin S., Pinna A., Polak W., Soubrane O., Clavien P.A. Proposal of a new comprehensive notation for hepatectomy: the “New World” terminology. Ann. Surg. 2021; 274 (1): 1–3. https://doi.org/10.1097/SLA.0000000000004808

34. Torzilli G., Procopio F., Viganò L., Cimino M., Costa G., del Fabbro D., Donadon M. Hepatic vein management in a parenchyma-sparing policy for resecting colorectal liver metastases at the caval confluence. Surgery. 2018; 163 (2): 277–284. https://doi.org/10.1016/J.SURG.2017.09.003

35. Torzilli G., Procopio F., Donadon M., del Fabbro D., Cimino M., Garcia-Etienne C.A., Montorsi M. Upper transversal hepatectomy. Ann. Surg. Oncol. 2012; 19 (11): 3566. https://doi.org/10.1245/S10434-012-2596-8.

36. Torzilli G., Procopio F., Viganò L., Costa G., Fontana A., Cimino M., Donadon M., del Fabbro D. The liver tunnel: intention-to-treat validation of a new type of hepatectomy. Ann. Surg. 2019; 269 (2): 331–336. https://doi.org/10.1097/SLA.0000000000002509

37. Tien-Yu L., Kai-Mo C., Tang Kue Liu. Total right hepatic lobectomy for primary hepatoma. Surgery. 1960; 48 (6): 1048–1060.

38. Chirurgied’Exérèse du Foie. By Ton That Tung, 7 1/2 × 5 in. Pp. 336, with 70 illustrations. 1963. Paris: Masson et Cie. 25 F. British J. Surg. 2005; 50 (227): 991–991. https://doi.org/10.1002/BJS.18005022726

39. Takasaki K., Kobayashi S. A new method of systematic hepatectomy by on bloc ligation of Glissonian pedicles. Operation. 1986; 40: 7–14.

40. Гальперин Э.И., Мочалов А.М. Пальцевое чреспеченочное выделение сосудисто-секреторных ножек долей и сегментов при анатомических резекциях печени. Хирургия. Журнал им. Н.И. Пирогова. 1986; 7: 3–9. Galperin E.I., Mochalov A.M. Digital transhepatic isolation of vascular and secretory fascicles of liver lobes and segments at liver anatomic resections. Pirogov Russian Journal of Surgery = Khirurgiya. Zhurnal im. N.I. Pirogova. 1986; 7: 3–9. (In Russian)

41. Launois B., Jamieson G. The posterior intrahepatic approach for hepatectomy or removal of segments of the liver. Surg. Gynecol. Obstet. 1992; 174 (2): 155–158.

42. Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J. Hepatobiliary Pancreat. Surg. 1998; 5 (3): 286–291. https://doi.org/10.1007/S005340050047

43. Sugioka A., Kato Y., Tanahashi Y. Systematic extrahepatic Glissonean pedicle isolation for anatomical liver resection based on Laennec’s capsule: proposal of a novel comprehensive surgical anatomy of the liver. J. Hepatobiliary Pancreat. Sci. 2017; 24 (1): 17–23. https://doi.org/10.1002/JHBP.410

44. Urade T., Sawa H., Iwatani Y., Abe T., Fujinaka R., Murata K., Mii Y., Man-i M., Oka S., Kuroda D. Laparoscopic anatomical liver resection using indocyanine green fluorescence imaging. Asian J. Surg. 2020; 43 (1): 362–368. https://doi.org/10.1016/J.ASJSUR.2019.04.008

45. Kubo N., Araki K., Harimoto N., Ishii N., Tsukagoshi M., Igarashi T., Watanabe A., Shirabe K. Hepatic resection for the right hepatic vein drainage area with indocyanine green fluorescent imaging navigation. J. Hepatobiliary Pancreat. Sci. 2020; 27 (7): 371–379. https://doi.org/10.1002/JHBP.728

46. Sato F., Igami T., Ebata T., Yokoyama Y., Sugawara G., Mizuno T., Nagino M. A study of the right intersectional plane (right portal scissura) of the liver based on virtual left hepatic trisectionectomy. World J. Surg. 2014; 38 (12): 3181–3185. https://doi.org/10.1007/S00268-014-2718-5

47. Rotellar F., Martí-Cruchaga P., Zozaya G., Tuero C., Luján J., Benito A., Hidalgo F., López-Olaondo L., Pardo F. Standardized laparoscopic central hepatectomy based on hilar caudal view and root approach of the right hepatic vein. J. Hepatobiliary Pancreat. Sci. 2020; 27 (1): E7–8. https://doi.org/10.1002/JHBP.669

48. Monden K., Sadamori H., Hioki M., Ohno S., Takakura N. Laparoscopic anatomic liver resection of the dorsal part of segment 8 using an hepatic vein-guided approach. Ann. Surg. Oncol. 2022; 29 (1): 341. https://doi.org/10.1245/S10434-021-10488-Y

49. Homma Y., Honda G., Kurata M., Ome Y., Doi M., Yamamoto J. Pure laparoscopic right posterior sectionectomy using the caudate lobe-first approach. Surg. Endosc. 2019; 33 (11): 3851–3857. https://doi.org/10.1007/S00464-019-06877-W

50. Kiguchi G., Sugioka A., Kato Y., Uyama I. Use of the interLaennec approach for laparoscopic anatomical right posterior sectionectomy in semi-prone position. Surg. Oncol. 2019; 29: 140–141. https://doi.org/10.1016/J.SURONC.2019.05.001

51. Okuda Y., Honda G., Kurata M., Kobayashi S., Sakamoto K. Dorsal approach to the middle hepatic vein in laparoscopic left hemihepatectomy. J. Am. Coll. Surg. 2014; 219 (2): 1–4. https://doi.org/10.1016/J.JAMCOLLSURG.2014.01.068

52. Ome Y., Honda G., Kawamoto Y. Laparoscopic left hemihepatectomy by the Arantius-first approach: a video case report. J. Gastrointestinal. Surg. 2020; 24 (9): 2180–2182. https://doi.org/10.1007/S11605-020-04683-7/FIGURES/5

53. Rotellar F., Martí-Cruchaga P., Zozaya G., Benito A., Hidalgo F., López-Olaondo L., López-Ben S., Pardo F. Caudal approach to the middle hepatic vein as a resection pathway in difficult major hepatectomies under laparoscopic approach. J. Surg. Oncol. 2020; 122 (7): 1426–1427. https://doi.org/10.1002/JSO.26150

54. Sato F., Igami T., Ebata T., Yokoyama Y., Sugawara G., Mizuno T., Nagino M. A study of the right intersectional plane (right portal scissura) of the liver based on virtual left hepatic trisectionectomy. World J. Surg. 2014; 38 (12): 3181–3185. https://doi.org/10.1007/S00268-014-2718-5

55. Nishino H., Hatano E., Seo S., Nitta T., Saito T., Nakamura M., Hattori K., Takatani M., Fuji H., Taura K., Uemoto S. Realtime navigation for liver surgery using projection mapping with indocyanine green fluorescence: development of the novel medical imaging projection system. Ann. Surg. 2018; 267 (6): 1134–1140. https://doi.org/10.1097/SLA.0000000000002172


Рецензия

Для цитирования:


Ахаладзе Г.Г., Иванова О.А. Современные тенденции в хирургии печени. Анналы хирургической гепатологии. 2022;27(4):15-22. https://doi.org/10.16931/1995-5464.2022-4-15-22

For citation:


Akhaladze G.G., Ivanova O.A. Current trends in liver surgery (literature review). Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2022;27(4):15-22. (In Russ.) https://doi.org/10.16931/1995-5464.2022-4-15-22

Просмотров: 494


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 1995-5464 (Print)
ISSN 2408-9524 (Online)