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Computer planned, image-guided combined resection and ablation for bilobar colorectal liver metastases.
Journal article

Computer planned, image-guided combined resection and ablation for bilobar colorectal liver metastases.

  • Banz VM Vanessa M Banz, Matthias Baechtold, Daniel Inderbitzin, Daniel Candinas, Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, CH-3010 Berne, Switzerland.
  • Baechtold M Vanessa M Banz, Matthias Baechtold, Daniel Inderbitzin, Daniel Candinas, Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, CH-3010 Berne, Switzerland.
  • Weber S Vanessa M Banz, Matthias Baechtold, Daniel Inderbitzin, Daniel Candinas, Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, CH-3010 Berne, Switzerland.
  • Peterhans M Vanessa M Banz, Matthias Baechtold, Daniel Inderbitzin, Daniel Candinas, Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, CH-3010 Berne, Switzerland.
  • Inderbitzin D Vanessa M Banz, Matthias Baechtold, Daniel Inderbitzin, Daniel Candinas, Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, CH-3010 Berne, Switzerland.
  • Candinas D Vanessa M Banz, Matthias Baechtold, Daniel Inderbitzin, Daniel Candinas, Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, CH-3010 Berne, Switzerland.
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  • 2014-10-31
Published in:
  • World journal of gastroenterology. - 2014
Colorectal liver metastases
Computer navigation
Image-guidance
Microwave ablation
Tumor
Ablation Techniques
Colorectal Neoplasms
Disease Progression
Fatal Outcome
Hepatectomy
Humans
Liver Neoplasms
Microwaves
Middle Aged
Palliative Care
Predictive Value of Tests
Surgery, Computer-Assisted
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
English For patients with extensive bilobar colorectal liver metastases (CRLM), initial surgery may not be feasible and a multimodal approach including microwave ablation (MWA) provides the only chance for prolonged survival. Intraoperative navigation systems may improve the accuracy of ablation and surgical resection of so-called "vanishing lesions", ultimately improving patient outcome. Clinical application of intraoperative navigated liver surgery is illustrated in a patient undergoing combined resection/MWA for multiple, synchronous, bilobar CRLM. Regular follow-up with computed tomography (CT) allowed for temporal development of the ablation zones. Of the ten lesions detected in a preoperative CT scan, the largest lesion was resected and the others were ablated using an intraoperative navigation system. Twelve months post-surgery a new lesion (Seg IVa) was detected and treated by trans-arterial embolization. Nineteen months post-surgery new liver and lung metastases were detected and a palliative chemotherapy started. The patient passed away four years after initial diagnosis. For patients with extensive CRLM not treatable by standard surgery, navigated MWA/resection may provide excellent tumor control, improving longer-term survival. Intraoperative navigation systems provide precise, real-time information to the surgeon, aiding the decision-making process and substantially improving the accuracy of both ablation and resection. Regular follow-ups including 3D modeling allow for early discrimination between ablation zones and recurrent tumor lesions.
Language
  • English
Open access status
hybrid
Identifiers
Persistent URL
https://sonar.ch/global/documents/138938
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