Liver metastasis is the presence of tumor mass in the liver or in liver tissue as a result of the extension of a cancer and located in another organ or tissue in the body.
This extension can be:
- many nodules
- A mass
- several masses
The difference between the nodule and nodule mass is that the size is less than 4.5 cm, while the mass is greater than 4-5 cm.
Causes of liver metastases
Metastasis occurs because the cancer cells reach the liver via the blood, either ischemic or blood circulation. The most common sites that generate liver tumor metastases are cancers of the colon and rectum and overall digestive cancers (pancreatic cancer, stomach cancer, small bowel cancer, etc.). However, any tumor of any part of the body is susceptible when it spreads to make liver metastases.
Surgical techniques for liver metastases
Surgical techniques for treating liver metastasis can be understood as two distinct classifications:
- Extent of surgical procedure performed: can be hepatectomy (liver resection) more or less. In major liver resections, three or four segments hepatic (liver liver is divided into eight segments differ in that each has its arterial, venous and biliary drainage contribution) are removed.
- Surgical approach: it can be open or laparoscopic. Refers to the conventional open incisions are usually extensive below the ribs on the right side. Laparoscopic surgery is a minimally invasive which is performed through small incisions between 0.5 and 2 centimeters and through which the segments are excised liver metastases. Not all liver resections can be performed laparoscopically, but there are more favorable for this option segments.
Indications for surgery of liver metastases
The type of liver resection depends on the location of liver metastases and number thereof. Approach for minimally invasive surgery, the ideal is the only liver metastases located in peripheral segments.
When it comes to major liver resections or have to remove large tumor mass, the priority is always the safety of the patient and by open approach allows more vascular control and better control of blood loss.
Usually open surgery is indicated which is for most cases of liver resections. The laparoscopic surgery is reserved for selected patients with small lesions and located in favorable segments.
Duration of surgery of liver metastases
The duration depends on the type of resection and the surgical approach used:
- open resections under way: between 90 minutes and three hours on average.
- major resections open surgery: three to five hours.
However, the duration will always depend on the experience of the surgeon and the type of material used, key elements in liver surgery so that patient outcomes are most favorable.
Postoperative liver metastasis surgery
When the procedure is performed by experienced teams and high volume hospitals, postoperative patients is favorable. The hospital stay after intervention (provided it has not perform complex vascular resections) usually lasts between three and five days. Laparoscopic surgery usually minimize postoperative pain, although not shown to shorten the patient's hospital stay. Ultimately, surgery of liver metastases may be considered surgery today high security and excellent postoperative course when performed by experienced surgeons in high - volume centers.