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This book describes the diagnoses; staging and management of patients with colorectal liver metastases initially considered unresectable and portrays the different strategies to increase resectability along with their tactics and tricks. Colorectal carcinoma is the third most commonly diagnosed cancer in the world and according to recent cancer statistics around 1.23 million patients are diagnosed each year. Of these patients, approximately 50% will develop liver metastases during the course of their disease and around 15-25% are found to have stage IV disease at diagnosis. Liver resection has been recognized as the treatment of choice for these patients, offering overall 5-year survival rates of up to 50-60% and the only hope for cure. However, at diagnosis only 10-20% of these patients are possibly amenable to surgical resection with curative intent. The possibility to achieve an R0 resection is many times limited by the amount and quality of the future liver remnant (FLR), being posthepatectomy liver failure (PHLF) the most feared and severe complication after major liver resections. With the years, diverse strategies have been developed with the intention to increase resectability by increasing the future liver remnant and/or reducing tumor size, e.g. ALPPS. Along with these techniques, associated surgeries are developed including multivisceral resections, which broadens even more the resectability for patients.
This volume is a complete manual of operative techniques for battling a severe liver injury. It provides an easy pre-operative and intra-operative reference with clear illustrations, line drawings as well as actual intra-operative color pictures, supplemented by online video segments. The early sections of the book deal with the fundamentals of surgical anatomy and critical maneuvers in the resuscitation of the patient in extremis. The various technical maneuvers for manual control of hemorrhage, debridement-resection as well as formal lobectomy of the liver, the identification of biliary tract injuries and other miscellaneous techniques, such as balloon tamponade of missile tracts, are discussed in complete detail. The book also sketches the role of liver transplantation surgeons in the acute trauma setting. The final chapters focus on the urgent problem of teaching operative techniques to young trauma surgeons in an era of dwindling surgical experience. Written by authors who are world- renowned experts in trauma management, often termed “master-surgeons”, Operative Techniques for Severe Liver Injury is required preparation for all surgeons who are likely to face a massive crush injury of the liver.
Public health and in health policy courses at the undergraduate and graduate level.
Chronic liver failure is a frequent condition in clinical practice that encompasses all manifestations of patients with end-stage liver diseases. Chronic liver failure is a multiorgan syndrome that affects the liver, kidneys, brain, heart, lungs, adrenal glands, and vascular, coagulation, and immune systems. Chronic Liver Failure: Mechanisms and Management covers for the first time all aspects of chronic liver failure in a single book, from pathogenesis to current management. Each chapter is written by a worldwide known expert in their area and all provide the latest state-of-the-art knowledge. This volume is specifically designed to provide answers to clinical questions to all doctors dealing with patients with liver diseases, not only clinical gastroenterologists and hepatologists, but also to internists, nephrologists, intensive care physicians, and transplant surgeons.
One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.
Colorectal cancer is the third most commonly diagnosed condition in oncology, affecting around 1.23 million individuals per year, according to recent statistics. Of these patients, about 50% will develop liver metastases and approximately 20% will present a stage IV disease at diagnosis. These statistics make colorectal liver metastases (CLM) an issue of major importance in current oncology. The area of CLM is subject to great and continuous advances, as its pathophysiologic mechanisms are better understood and more therapeutic and surgical options are developed. Consequently, all professionals involved with the diagnosis, treatment and follow up of CLM should be kept up to date with the latest advances on the field, to provide high standard medical care to their patients. This book is designed to present the state-of-the-art in CLM management and, in doing so, to review the current evidence on CLM, discussing all important topics in the field. Coverage is broad and comprehensive, encompassing introductory topics (history, definitions, epidemiology, etc.), basic science subjects (molecular biology, genetics, dissemination process, etc.) and practical clinical topics (tumor behavior, diagnosis, drug therapy, radiation therapy, surgery, ablation, multidisciplinary teams, etc.). Although comprehensive on the coverage and selection of topics, each chapter is concise and objective, dissecting topics in a practical and direct format. Evidences and recommendations are included. Chapters display a brief introduction of the common knowledge, go straight to the detailed revision of the most recent years of the literature, and end with practical closing observations. This book is a tool for professionals (general and cancer surgeons, HPB surgeons, clinical oncologists, gastroenterologists and medical residents) and interns who search for a qualified and reader friendly revision on topics concerning Colorectal Cancer Liver Metastases.
This unique textbook provides a concise and practical approach to clinical dilemmas involving the liver, pancreas, and biliary tree. Six major sections encompass (1) Hepatic, (2) Biliary, (3) Pancreas, (4) Transplantation, (5) Trauma, and (6) Innovative Technology. Each topic is written by recognized experts from an "e;experiential"e; viewpoint combined with evidence-based medicine. The book contains over 170 chapters and over 350 contributors. It is relevant to Surgical Oncologists, Hepato-Pancreato-Biliary (HPB) Surgeons, Transplant Surgeons, Traumatologists, HPB Interventionalists, General Surgeons, and trainees and students. The title of each chapter is in a form of a clinical scenario and each chapter begins with a Case Scenario and ends with Salient Points. Special debates are included in each section. There are numerous compelling images, detailed illustrations, comprehensive tables, thorough algorithms, and other adjunctive tools that enhance learning. The authors emanate from different corners of the world. The book is a valuable resource for faculty, students, surgical trainees, fellows, and all health care providers in the HPB/Trauma/Transplant/Oncology fields.
The 2nd edition of the successful book also summarises the factual knowledge of visceral surgery in a condensed, keyword-like form. It is suitable for preparation for the specialist examination as well as for quick reference in everyday clinical practice. All articles have been written by renowned experts. The focus is on detailed recommendations on the diagnostic procedure, the indication and the implementation of therapy; for the most important interventions, the steps of the surgical procedure are also presented. Brief overviews facilitate the targeted memorisation of the most important facts.
This book provides a comprehensive overview of the current limitations and unmet needs in Hepatocellular Carcinoma (HCC) diagnosis, treatment, and prevention. It also provides newly emerging concepts, approaches, and technologies to address challenges. Topics covered include changing landscape of HCC etiologies in association with health disparities, framework of clinical management algorithm, new and experimental modalities of HCC diagnosis and prognostication, multidisciplinary treatment options including rapidly evolving molecular targeted therapies and immune therapies, multi-omics molecular characterization, and clinically relevant experimental models. The book is intended to assist collaboration between the diverse disciplines and facilitate forward and reverse translation between basic and clinical research by providing a comprehensive overview of relevant areas, covering epidemiological trend and population-level patient management strategies, new diagnostic and prognostic tools, recent advances in the standard care and novel therapeutic approaches, and new concepts in pathogenesis and experimental approaches and tools, by experts and opinion leaders in their respective fields. By thoroughly and concisely covering whole aspects of HCC care, Hepatocellular Carcinoma serves as a valuable reference for multidisciplinary readers, and promotes the development of personalized precision care strategies that lead to substantial improvement of disease burden and patient prognosis in HCC.
Principles of Hepatic Surgery introduces the reader to current trends in Liver surgery knowledge and practice. This reference book covers liver surgery fundamentals as well as cutting-edge progress in this exciting surgical specialty. Contributions have been written by expert hepatic surgeons from major medical centers around the world. Key features include:Information organized into five comprehensive sections: i) Liver Anatomy and Perioperative Care, ii) Approach to Malignant Hepatic Disease, iii) Approach to Benign Hepatic Disease, iv) Technical Aspects of Liver Resections, and v) Liver Transplantation Over 350 illustrations Truly effective didactic text, with logical, clear explanations, giving readers a pleasant reading experience Commentary sections written by experts for specific surgical cases. Principles of Hepatic Surgery is a valuable reference for both novice hepatologists and practicing liver surgeons.