Erschienen in:
03.10.2022 | ASO Author Reflections
ASO Author Reflections: Anatomical Extended Right Posterior Sectionectomy: A New Surgical Strategy for Right Liver Tumor in the Digital Intelligent Liver Surgery Era
verfasst von:
Xiaojun Zeng, MD, Jian Yang, PhD, Chihua Fang, PhD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 1/2023
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Excerpt
In the past decades, right hepatectomy (RH) has been a commonly used surgical procedure for patients with hepatocellular carcinoma (HCC) in the right liver.
1 However, RH often requires removing large amounts of normal hepatic parenchyma. Patients with insufficient future liver remnant volume (FLRV) may need a two-stage hepatectomy. The systematic extended right posterior sectionectomy (SERPS), proposed by Torzilli et al.
2 in 2008, preserves most of the liver parenchyma of the right anterior section (RAS), and this approach is a feasible, safe, and effective alternative to RH. The SERPS, which allows a one-stage surgery to achieve a radical resection while preserving a more functional liver parenchymal, is a non-anatomic liver resection, which may lead to remnant liver ischemia and increase the occurrence of postoperative complications.
3 Meanwhile, there are difficulties with anatomic hepatectomies, such as determining the extent of subsegments resection preoperatively and performing dissection along the accurate resection plane between segments or subsegments during liver parenchyma transection, especially under laparoscopy.
4 …
