title: Do the tumor cells of hepatocellular carcinomas dislodge into the portal venous stream during hepatic resection?
abstract: BACKGROUND
  The current study was undertaken to investigate whether or not tumor cells are dislodged into the portal venous stream during hepatic resection for hepatocellular carcinomas.
  
  
  METHODS
  A catheter was placed using echo guidance into the portal branch through the mesenteric vein in 31 patients. Cytologic examinations were done on multiple blood samples at various operative stages.
  
  
  RESULTS
  Tumor cells were recovered in 7 of 31 patients in whom the tumor sizes were more than 5 cm and portal invasions were found microscopically and/or macroscopically. By contrast, the remaining 24 tumors were less than 5 cm in size and showed negative portal invasions. Recovery of the tumor cells was found, not during the earlier operative stage of mobilization or rotation of the hepatic lobe, but during the later stages of hilar dissection or hepatic parenchymal dissection.
  
  
  CONCLUSIONS
  The portal pedicles should be divided before hepatic dissection in segmentectomy and lobectomy to lessen the chance of dissemination of intravasated tumor cells.
authors.affiliation: First Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yamanaka
authors.forename: E
authors.initials: E
authors.lastname: Okamoto
authors.forename: S
authors.initials: S
authors.lastname: Fujihara
authors.forename: T
authors.initials: T
authors.lastname: Kato
authors.forename: J
authors.initials: J
authors.lastname: Fujimoto
authors.forename: T
authors.initials: T
authors.lastname: Oriyama
authors.forename: M
authors.initials: M
authors.lastname: Mitsunobu
authors.forename: A
authors.initials: A
authors.lastname: Toyosaka
authors.forename: K
authors.initials: K
authors.lastname: Uematsu
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D004210:Dissection; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009366:Neoplasm Seeding; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011169:Portal Vein / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome