Effect of translocation of cirrhotic liver on hepatic venous hemoglobin oxygen saturation during hepatectomy.
OBJECTIVE
Comparison of conventional abdominal approach and right thoracoabdominal approach for the resection of hepatocellular carcinoma in cirrhotic liver located at right upper lobe was made in accordance with the effect of translocation of right lobe on hepatic venous hemoglobin oxygen saturation.


METHODS
From 1990-1994, 92 initial hepatectomies were performed in patients with hepatocellular carcinoma at our department. Nine patients underwent resections of hepatocellular carcinoma located at the right upper lobe with the right thoracoabdominal approach. On the other hand, 10 patients underwent resections of hepatocellular carcinoma at the same location but with the abdominal approach. We evaluated the effect of translocation of liver by monitoring the hepatic venous hemoglobin oxygen saturation.


RESULTS
The outcome was favorable for the right thoracoabdominal approach for those patients with liver cirrhosis considering less reduction in frequency and degree of hepatic venous hemoglobin oxygen saturation during operation.


CONCLUSIONS
The right thoracoabdominal approach may cause less damage to the liver with severe cirrhosis and preferable to this type of operation compare to the abdominal approach.
First Department of Surgery, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
K
K
Koguchi
N
N
Matsubara
K
K
Hamazaki
G
G
Nowak
H
H
Isozaki
N
N
Tanaka
D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins; D006801:Humans; D007432:Intraoperative Period; D008103:Liver Cirrhosis / Q000150:complications*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D011183:Postoperative Complications
D006454:Hemoglobins; D010100:Oxygen