An approach to the intra-thoracic inferior vena cava through the abdominal cavity preparing for total hepatic vascular exclusion by sagittal diaphragmotomy

Shugo Mizuno, Masahiro Yagihara, Akihiro Tanemura, Naohisa Kuriyama, Yoshinori Azumi, Masashi Kishiwada, Ichiro Ohsawa, Masanobu Usui, Hiroyuki Sakurai, Masami Tabata, Masayuki Miyabe, Shuji Isaji

Research output: Contribution to journalArticle

Abstract

Background/Aims: For resection of advanced liver tumors with tumor thrombus/invasion extending into the intra-thoracic inferior vena cava (IVC) above the diaphragm as well as huge liver tumors located at the root of hepatic vein, an appropriate approach to the intra-thoracic IVC through the abdominal cavity is the key to control the intraoperative massive bleeding. Methodology: Surgical technique: The pericardium and diaphragm are separated by using fingers without injury of the pericardium. From just below the xiphoid process to the IVC, the diaphragm is vertically dissected without cutting the pericardium and doing median sternotomy. Then the intra-thoracic IVC is exposed easily and encircled with an umbilical tape. Results: This technique was applied in four patients (hepatocellular carcinoma: n = 3, cholangiocellular carcinoma: n = 1). The mean patient's age was 69 (59-81) year old, and three were male. The median duration of surgery and blood loss was 490 min and 3600 mL, respectively. The median peaked aspartate aminotransferase and total bilirubin was 428 IU/mL and 2.75 mg/dL, respectively. The median duration of hospital stay was 22 days. Conclusions: This approach to intra-thoracic IVC through the abdominal cavity is very beneficial and helpful for many liver surgeons.

Original languageEnglish
Pages (from-to)1409-1412
Number of pages4
JournalHepato-gastroenterology
Volume60
Issue number126
DOIs
Publication statusPublished - 01-09-2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Fingerprint Dive into the research topics of 'An approach to the intra-thoracic inferior vena cava through the abdominal cavity preparing for total hepatic vascular exclusion by sagittal diaphragmotomy'. Together they form a unique fingerprint.

  • Cite this

    Mizuno, S., Yagihara, M., Tanemura, A., Kuriyama, N., Azumi, Y., Kishiwada, M., Ohsawa, I., Usui, M., Sakurai, H., Tabata, M., Miyabe, M., & Isaji, S. (2013). An approach to the intra-thoracic inferior vena cava through the abdominal cavity preparing for total hepatic vascular exclusion by sagittal diaphragmotomy. Hepato-gastroenterology, 60(126), 1409-1412. https://doi.org/10.5754/hge121321