Simultaneous Approach of Colo-Rectal and Hepatic Lesions in Colo-Rectal Cancers with Liver Metastasis - A Single Oncological Center Overview.

Management of synchronous colorectal cancer with liver metastases (SCLM) is still on debate, regarding timing, indications and complications of the 3 strategies: classic approach (first tumor resection), simultaneous resection and reverse approach (liver first). A retrospective single-centre evaluation of synchronous approach was accomplished, focusing on surgical technique, indications and complications. Material and Between 2017 and 2020, 31 SCLM patients benefited from synchronously colorectal and hepatic approach: segmental colectomies/rectal resections, simultaneously with liver metastasectomies (associated with radiofrequency ablation).

Immediate and Long-term Results of Radiofrequency Ablation for Colorectal Liver Metastases.

Background/aim: Radiofrequency ablation (RFA) of colorectal liver metastases (CRLMs) is a method developed in the last 15 years. It provides an acceptable control of the malignant process with lower risks compared to surgical resection. The aim of the study was to assess immediate and long-term results, including recurrence, survival, morbidity/mortality rates after RFA.

Intraoperative cholangiography still a current investigation.

Laparoscopic cholecystectomy is the standard treatment for patients requiring gallbladder removal. Although the advantages of the laparoscopic technique are widely accepted, the introduction of this technique has doubled the rate of iatrogenic lesions of extrahepatic bile ducts. Research methods for biliary tree also evolved, but intraoperative cholangiography, the traditional exploring method used for the biliary tree in classic cholecystectomy remains a valuable investigation in the laparoscopic technique.

The role of intraoperative ultrasound in establishing the surgical strategy regarding hepato-bilio-pancreatic pathology.

Intraoperative ultrasound examination plays a more and more important role in open or laparoscopic abdominal surgery,satisfying the surgeon's need to correctly characterize lesions,bringing various benefits regarding topography and local regional extension, relations between neighbouring structures and, finally, disease staging. Intraoperative ultrasound is used especially in hepato-bilio-pancreatic tract interventions, given its diagnostic and therapeutic values. Between 2009-2012 in the IOB First Surgery Clinic 57 intraoperative echo graphies were performed, in patients with hepato-bilio-pancreatic pathologies, leading to intraoperative guided punctures with diagnostic or therapeutic purpose (in case of hepatic abscesses),detection of new hepatic metastases, their ablation under ultrasound guidance, exploration of the local-regional topography with the aim of an optimal hepatic resection.

Extending indication for radiofrequency ablation (RFA) in cancer surgery.

Radiofrequency ablation (RFA) represents one of the successful methods for the thermal ablation of unresectable tumors. The tumoricidal effect of this method consists in the tissular conversion of electromagnetic energy into thermal energy. The term refers to the electric current, whose frequencies reach high values, 480 KHz on average.