1. Two-stage hepatectomy in resection of colorectal liver metastases - a single-institution experience with case-control matching and review of the literatureŠpela Turk, Irena Plahuta, Tomislav Magdalenić, Tajda Španring, Kevin Laufer, Žan Mavc, Stojan Potrč, Arpad Ivanecz, 2023, original scientific article Keywords: colorectal cancer, liver metastasis, future liver remnant, posthepatectomy liver failure
Published in DiRROS: 25.07.2024; Views: 474; Downloads: 363
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7. Pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head with venous resectionVojko Flis, Stojan Potrč, Nina Kobilica, Arpad Ivanecz, 2016, original scientific article Abstract: Background. Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surgical technique of vessel reconstruction (resection with or without graft reconstruction). As published series are small the aim of this study was to evaluate our experience in pancreatectomies with en bloc vascular resection and reconstruction of vessels. Methods. Review of database at University Clinical Centre Maribor identified 133 patients (average age 65.4 +/- 8.6 years, 69 female patients) who underwent pancreatoduodenectomy between January 2006 and August 2014. Clinical data, operative results, pathological findings and postoperative outcomes were collected prospectively and analyzed. Current literature and our experience in pancreatectomies with en bloc vascular resection and reconstruction of portal vein are reviewed. Results. Twenty-two patients out of 133 (16.5 %) had portal vein-superior mesenteric vein resection and portal vein reconstruction (PVR) during pancreaticoduodenectomy. In fourteen patients portal vein was reconstructed without the use of synthetic vascular graft. In these series two types of venous reconstruction were performed. When tumour involvement was limited to the superior mesenteric vein (SPV) or portal vein (PV) such that the splenic vein could be preserved, and vessels could be approximated without tension a primary end-to-end anastomosis was performed. When tumour involved the SMV-splenic vein confluence, splenic vein ligation was necessary. In the remaining eight procedures interposition graft was needed. Dacron grafts with 10 mm diameter were used. There was no infection after dacron grafting. One patient had portal vein thrombosis after surgery: it was thrombosis after primary reconstruction. There were no thromboses in patients with synthetic graft interposition. There were no significant differences in postoperative morbidity, mortality or grades of complication between groups of patients with or without a PVR. Median survival time in months was in a group with vein resection 16.13 months and in a group without vein resection 15.17 months. Five year survival in the group without vein resection was 19.5%. Comparison of survival curves showed equal hazard rates with log-rank p = 0.090. Conclusions. Survival of patients with pancreatic cancer who undergo an R0 resection with reconstruction was comparable to those who have a standard pancreaticoduodenectomy with no added mortality or morbidity. Synthetic graft appeared to be an effective and safe option as an interposition graft for portomesenteric venous reconstruction after pancreaticoduodenectomy.
Published in DiRROS: 09.05.2024; Views: 531; Downloads: 287
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8. Thoracobiliary fistulas : literature review and a case report of fistula closure with omentum majusAnton Crnjac, Vid Pivec, Arpad Ivanecz, 2013, review article Abstract: Background. Thoracobiliary fistulas are pathological communications between the biliary tract and the bronchial tree (bronchobiliary fistulas) or the biliary tract and the pleural space (pleurobiliary fistulas). Review of the literature. We have reviewed aetiology, pathogenesis, predilection formation points, the clinical picture, diagnostic possibilities, and therapeutic options for thoracobiliary fistulas. Case report. A patient with an iatrogenic bronchobiliary fistula which developed after radiofrequency ablation of a colorectal carcinoma metastasis of the liver is present. We also describe the closure of the bronchobiliary fistula with the greater omentum as a possible manner of fistula closure, which was not reported previously according to the knowledge of the authors. Conclusions. Newer papers report of successful non-surgical therapy, although the bulk of the literature advocates surgical therapy. Fistula closure with the greater omentum is a possible method of the thoracobiliary fistula treatment.
Keywords: thoracobiliary fistula, bronchobiliary fistula, therapy, omentum majus
Published in DiRROS: 22.03.2024; Views: 660; Downloads: 201
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9. Hepatocelični rak - možnost resekcije jeterArpad Ivanecz, Marko Sremec, Tomaž Jagrič, Stojan Potrč, 2014, original scientific article Abstract: Resekcija jeter (RJ) je ostala glavna oblika terapije pri solitarnem hepatoceličnem raku (HCC), pri bolnikih z ohranjeno funkcijsko rezervo jeter in v primernem splošnem stanju. Izpopolnjene slikovne preiskave so pripomogle k boljši izbiri bolnikov. Kirurgija jeter je napredovala: uporabne so številne tehnike transekcije jetrnega tkiva; dosegljive so različne naprave, ki omogočajo hitrejše in natančnejše operiranje v brezkrvnem operativnem polju. Izboljšana kirurška tehnika, vzdrževanje nizkega centralnega venskega pritiska in napredek pri negi bolnika po operaciji so omogočili, da se je smrtnost po operaciji jeter v izbranih serijah znižala celo do 0%. Barcelona Clinic Liver Cancer (BCLC) klasifikacija poleg zamejitve bolezni, nudi priporočila tudi glede izbora terapije. Kirurško terapijo omejuje zgolj na bolnike z zgodnjim stadijem raka. Namen tega prispevka je raziskati, ali je v sedanjem času mogoče RJ opraviti s sprejemljivimi kratko- in dolgoročnimi rezultati tudi pri bolnikih s takšnim HCC, pri katerem so prisotni številni in veliki tumorji, ki makroskopsko vdirajo v žile.
Keywords: jetra, hepatocelični rak, resekcija, kirurški postopki, operativni, zapleti, smrtnost, preživetje
Published in DiRROS: 08.12.2020; Views: 1859; Downloads: 967
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10. Ponovne operacije jeter pri recidivu zasevkov raka debelega črevesa in dankeArpad Ivanecz, Jasmina Golc, Jasna Zakelšek, Marko Sremec, Stojan Potrč, 2013, review article Abstract: Pri polovici bolnikov z rakom debelega črevesa in danke se lahko pojavijo zasevki v jetrih. Multidisciplinarna obravnava predstavlja temelj uspešnega zdravljenja, resekcija jeter pa je edina potencialno kurativna oblika terapije. Kljub uspešni operaciji pa se lahko jetrni zasevki kasneje ponovijo. Tudi v takšnem primeru je smiselno znova začeti zdravljenje, ki zajema kombinacijo kemoterapije, tarčnih zdravil in načrtovanja ponovnih jetrnih resekcij. Nekateri bolniki živijo brez ponovitve obolenja več let po začetku zdravljenja.
Keywords: jetra, kolorektalne novotvorbe, rak debelega črevesa, prognoza
Published in DiRROS: 31.08.2018; Views: 4151; Downloads: 1018
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