Transdiaphragmatic approach facilitates resection of large (>12 cm) liver tumors.

Background/purpose: Various (mostly transthoracic) techniques have been proposed to facilitate access to large tumors located in the upper part of the liver, close to the confluence of the major hepatic veins. The purpose of this study was to investigate the safety and efficacy of a transdiaphragmatic mobilization technique for resection of such tumors.

Methods: Twenty-one patients, with tumors ranging from 12 to 22 cm in diameter, underwent liver resections using our technique of diaphragmatic splitting, with the intention of achieving adequate exposure of the inferior vena cava and the hepatocaval junction.

Association between biliary complications and technique of hilar division (extrahepatic vs. intrahepatic) in major liver resections.

Background: Division of major vascular and biliary structures during major hepatectomies can be carried out either extrahepatically at the porta hepatic or intrahepatically during the parenchymal transection. In this retrospective study we test the hypothesis that the intrahepatic technique is associated with less early biliary complications.

Methods: 150 patients who underwent major hepatectomies were retrospectively allocated into an intrahepatic group (n = 100) and an extrahepatic group (n = 50) based on the technique of hilar division.

Selective hepatic vascular exclusion versus Pringle maneuver in major liver resections: prospective study.

Selective hepatic vascular exclusion (SHVE) and the Pringle maneuver are two methods used to control bleeding during hepatectomy. They are compared in a prospective randomized study, where 110 patients undergoing major liver resection were randomly allocated to the SHVE group or the Pringle group. Data regarding the intraoperative and postoperative courses of the patients are analyzed.

Adjuvant systemic therapy protocol for Dukes' B2 and C resectable colon carcinoma.

Aims And Background: Trials of adjuvant systemic therapy in high risk patients with Dukes' B2 and C colon cancer utilizing 5-fluorouracil-based regimens have been ongoing since the 1960s. The aim of this study was to compare the combination of 5-FU and leucovorin with the combination of 5-FU and alfa-2b interferon (IFN) in patients who had undergone "curative" resection foronocarcinoma.

Study Design: A total of 322 patients with histologically proven adenocarcinoma of the colon, Dukes' stage B2 and C, were entered in the study.