Survival after hepatectomy for colorectal metastases

Abstract

recurrent tumors located in segment VII and VIII or extrahepatic location, such as a subdiaphragm, a transthoracic transdiaphragmatic approach via thoracoscopy is feasible. Since the technique has the advantage of better intrathoracic exposure avoiding severe adhesiolysis, liver mobilization and possible hepatic congestion. We report a case of extrahepatic metastatic hepatocellular carcinoma that was successfully resected by transthoracic thoracoscopic metastasectomy. Methods: A 68-year-old male patient who has undergone posterior sectinectomy with caudate lobectomy (S1,6,7) and cholecystectomy under a diagnosis of hepatocellular carcinoma at 3 years ago, was admitted to our hospital for further evaluation of extrahepatic metastatic tumor. On liver dynamic computed tomography revealed a welldefined mass of 3.5 cm in diameter, in right subphrenic space with invading diaphragm and rt. adrenal gland. The imaging findings suggested an extrahepatic hepatocellular carcinoma that metastasized to the diaphragm. LFT was normal and AFP revealed 94.14 ng/ml. Results: We performed transthoracic thoracoscopic metastasectomy for subdiaphragmatic metastases of HCC and partial diaphragmatic resection and repair. The operation time was 3 hour 30 minutes and blood loss was 100 ml. The patient started a diet POD1 day and discharged POD 11days due to chest tube. The postoperative course was uneventful, and the patient was discharged without any complications. Conclusions: Transthoracic thoracoscopic metastasectomy can be feasible even if the recurrent tumors located in segments VII and VIII or extrahepatic location, such as a diaphragm.