APPLICATION OF A PORTAL VEINLIGATURE FOR PRIMARILY UNRESECTABLE COLORECTAL LIVER METASTASES
Journal Title: Българско списание за обществено здраве (Bulgarian Journal of Public Health) - Year 2017, Vol 0, Issue 3
Abstract
Selected patients with unresectable colorectal liver metastases (CRLM) may become resectable using a two-step approach with portal vein ligature (PVL). The purpose of this study is the evaluation of the results of the two-staged liver resections(LR) using PVL for CRLM in our clinic. Material and methods: During the period 2005-2015 year at the Clinic of hepatobiliary and transplant surgery, MMA-Sofia 290 curative LR for CRL were carried out . In 17 (5.9%) of them is used a two-stage approach with an initial PVL. Results: The reasons for unresectability were multinodularity of the disease in 70.6%, the size of LM (11.8%), poor location (17.6%). Synchronous LM was at 94% of the cases. Simultaneous resection of the primary tumor at the first operation carried out in 58.8% of the cases. During the second operation, at 94% of patients require a major LR. Patients completed a two-staged approach median survival was 40.43 m., with a median of 38.95 m.. Multivariate Cox-analysis found that extended right hemihepatectomy adversely affect survival in patients with two-stage hepatectomy (p = 0.023), increasing the risk over 6 times. Conclusion: The multidisciplinary approach is the most precise form, ensuring proper selection and behavior in patients under consideration for two-stage approach to optimize the therapeutic behavior and clinical outcomes.
Authors and Affiliations
Ivan Vasilevski, Ivelin Takorov, Vasil Mihailov, Tsonka Lukanova, Nikola Vladov
Keywords
Related Articles
- EP ID EP473270
- DOI -
- Views 55
- Downloads 0
Nutrition in children 1-5 years of age in Bulgaria - energy AND Macronutrient INTAKE
Children one to five years of age can be classified as risk population group concerning nutrition due to some particular physiological characteristics. Studies conducted up to now on children in this age group have estab...
RISK FACTORS FOR HEALTH AND WORK ABILITY OF JUDICIAL CLERKS
Introduction: The increase of work load in the courts of the bigger towns in the country in the last decade may affect the health and workability of the staff, including judiciary clerks. The aim of the study was to asse...
ANALYTICAL PROCEDURE FOR THE DETERMINATION OF TOTAL MERCURY IN FISH
Mercury is a toxic element that overaccumulates selectively in the kidneys, brain, pituitary, etc. This requires a strict control of its levels in the environment and food as well as reliable analytical procedures for ac...
NUTRITIONAL STATUS OF SCHOOLCHILDREN AGED 7-18 YEARS IN BULGARIA, 2011 NATIONAL NUTRITION SURVEY
Background: Obesity is a serious health concern for children and adolescents in Bulgaria. National surveys of nutritional status of the population, which were conducted in the period 1998-2008, thus, involving children f...
ALZHEIMER‘S DISEASE: MEDICAL STRATEGIES
Alzheimer‘s disease (AD) is a socially significant, progressive neurodegenerative disease characterized by worsening of cognitive functions, impairment of behavioral functions, reduction of daily activities, associated f...