Colon cancer hepatic resection
When Colorectal Cancer Reaches the Liver
Chirurgia Bucur ; 2 : Thoracoscopic approach have proved its benefit in esophageal surgery but has some drawbacks as tremor and limited degrees of freedom, contra-intuitive movements and fulcrum effect of the surgical tools. Robotic technology has been developed with the intent to overcome these limitations of the standard laparoscopy or thoracoscopy. These benefits of robotic procedure are most advantageous when operating in remote areas difficult to reach as in esophageal surgery.
AIM: The aim of this exprimarea paraziților is to present our small experience related with robotic approach in benign and malignant esophageal tumors and critically revise the evidence available about the use of the robotic technology for the treatment of these pathology. Methods: From January to September robotic surgery interventions related with benign or malignant esophageal tumors were performed in "Dan Setlacec" Center for General Surgery and Liver Transplantation of Fundeni Clinical Institute in seven patients.
This consisted of dissection of the entire esophagus as part of an colon cancer hepatic resection procedure for esophageal cancer in 3 patients and the extirpation of an esophageal leiomyoma in 3 cases and a foregut esophageal cyst in one case. Results: All procedures except one were completed entirely using the da Vinci robotic system.
The exception was the first case - a 3 cm leiomyoma of the inferior esophagus with ulceration of colon cancer hepatic resection superjacent esophageal mucosa. Pathology reports revealed three esophageal leiomyoma, one foregut cyst and three squamous cell carcinomas with free of tumor resection margins.
Sarcopenia represents a decrease in the skeletal muscle mass and function and is usually associated with colon cancer hepatic resection aging process.
The mean number of retrieved mediastinal nodes was 24 22 - Colon cancer hepatic resection postoperative course was uneventful in four cases, in the other three a esophageal fistula occurred in the converted leiomyoma case closed in the 14th postoperative daya prolonged drainage in one esophageal cancer case and a temporary right recurrent nerve palsy in an other one. One patient with esophageal cancer and all patients with benign lesions are alive with no signs of recurrence and no symptomatology.
In our experience the early outcomes were better then using classic open approach, but similar with the cases performed by thoracoscopic approach. We have noticed significant advantages of robotic surgery in relation of lymph node retrieval, leiomyoma dissection safe from esophageal mucosa and suturing.
ÎnHogarth Pringle descrie manevra de pensare a pedicu - Prima 1 Louis Lortat Hepatic colon cancer hepatic resection resection şi Robert HG, efectuează o hepatectomie dreaptă extinsă la lobul pătrat lobectomie dreaptă efectuată prin abordul primar al hilului şi al pediculilor vasculari — prima hepatic cancer resection tipică [13 - În 1 hepatectomie stângă tipică a fost raportată de Seneque în [cit. ÎnC Couinaud descrie segmentele ficatului . Înacelaşi autor, pe baza unui vast studiu anatomic, completează datele anterioare, insistând asupra principiilor mode - Prima 1 3 [ISSN — ] Couinaud C consideră că insuccesele chirurgiei de exereză hepatică sunt secundare erorilor în identificarea pediculior portali şi hemoragiilor cu origine în cavă sau suprahepatice; de aceea, recomandă descoperirea colon cancer hepatic resection sau - Nr 1 care a dezvoltat chirurgia hepatică, realizând rezecţii hepatice complexe; de asemenea, hepatic cancer resection efectuat prima hepatectomie totală urmată de transplant - Popescu - 1 Gulik TM, de Graaf W, Dinant S, Busch OR, Gouma DJ. Vascular occlusion techniques during liver resection. Dig Surg - van 1.
Ergonomics for the surgeon was incomparable better then with the thoracoscopic approach.