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- W3209405473 abstract "Introduction: Laparoscopic liver resection (LLR) can be challenging for tumors located in the posterior-segments due to the difficult access and reduced view. However the use of preoperative ICG injection for tumor detection together with intraoperative US, might help to overcome difficulties. Indeed, ICG fluorescence during liver resection could guide surgeons to follow a proper transection line. This tool may ensure safety and oncological efficiency, in particular when major vessels should be spared to avoid major liver resections in such kind of tumors with recurrence tendency. Method: The aim of this video is to present the technical aspects and the usefulness of Indocyanine Green Fluorescence (ICG) injection prior to surgery for a LLR of segments VII-VIII for large colorectal metastasis (CRLM). Results: The patient was a male of 56 years old man with a synchronous large colorectal metastasis (90 mm) located in segments VII-VIII. Medical history: left hemicolectomy and atypical gastric resection for colorectal adenocarcinoma (T4aN1bM1, K-Ras wild-type, BRAF -). Patient underwent 4 chemotherapy cycles with FOLFOX were performed to down-stage the metastasis. LLR of segments VII-VIII was performed; ICG prior to surgery was injected 4 days prior to surgery (0.5 mg/kg). ICG fluorescence was used during the LLR to better detect a proper transection line especially where the lesion got attached to dorsal VIII glissonian pedicle. Histology reported a colorectal metastasis (75 mm), R1 vascular resection (Parenchymal margin 7 mm). Operative time was 290 min, blood loss 200 cc. Hospital stay 4 days with no complications. Conclusion: Preoperative ICG injection may be an additional helpful tool to assist surgeons during LLR to detect more precisely a proper transection line, ensuring better safety and oncological efficiency, especially when major vessels should be spared to avoid major liver resections in such kind of tumors with recurrence tendency." @default.
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- W3209405473 date "2021-01-01" @default.
- W3209405473 modified "2023-09-27" @default.
- W3209405473 title "Minimally invasive surgery for CRLM located in the postero-superior segments. The advantages of preoperative ICG injection in tumour detection during liver transection" @default.
- W3209405473 doi "https://doi.org/10.1016/j.hpb.2021.08.678" @default.
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