Surgical management of hepatocellular carcinoma after Fontan procedure

被引:35
作者
Kwon, Steve [1 ]
Scovel, Lauren [2 ]
Yeh, Matthew [3 ]
Dorsey, David [4 ]
Dembo, Gregory [4 ]
Krieger, Eric V. [5 ]
Bakthavatsalam, Ramassmy [1 ]
Park, James O. [1 ]
Riggle, Kevin M. [1 ]
Riehle, Kimberly J. [1 ]
Yeung, Raymond S. [1 ]
机构
[1] Univ Washington, Dept Surg, 1959 NE Pacific St,Box 356410, Seattle, WA 98195 USA
[2] Med Univ S Carolina, Dept Surg, Charleston, SC 29425 USA
[3] Univ Washington, Dept Pathol, Seattle, WA 98195 USA
[4] Univ Washington, Dept Anesthesiol, Seattle, WA 98195 USA
[5] Univ Washington, Dept Med, Seattle, WA 98195 USA
关键词
Hepatocellular carcinoma (HCC); Fontan; resection; hepatectomy; single ventricle;
D O I
10.3978/j.issn.2078-6891.2015.009
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The Fontan operation has successfully prolonged the lives of patients born with single-ventricle physiology. A long-term consequence of post-Fontan elevation in systemic venous pressure and low cardiac output is chronic liver inflammation and cirrhosis, which lead to an increased risk of hepatocellular carcinoma (HCC). Surgical management of patients with post-Fontan physiology and HCC is challenging, as the requirement for adequate preload in order to sustain cardiac output conflicts with the low central venous pressure (CVP) that minimizes blood loss during hepatectomy. Consequently, liver resection is rarely performed, and most reports describe nonsurgical treatments for locoregional control of the tumors in these patients. Here, we present a multidisciplinary approach to a successful surgical resection of a HCC in a patient with Fontan physiology.
引用
收藏
页码:E55 / E60
页数:6
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