title: Middle hepatic vein reconstruction using a peritoneal patch: report of a case.
abstract: A 67-year-old male complaining of constipation with a change in stool caliber for several months visited our hospital in June 1999. A positive test for occult blood in the feces led to the disclosure of a type II carcinoma of the sigmoid colon with multiple liver metastases. A lymph node dissection with a sigmoidectomy disclosed no metastases histologically, so a left hepatectomy and enucleations of the metastases were performed. In addition, the invaded middle hepatic vein (MHV) was resected and repaired using a peritoneal patch. The patient's postoperative course was uneventful until July 2000, when computed tomography of the liver showed a single nodule measuring 3 cm in diameter in segment 6. The metastasis was excised in August. Since then, the patient has shown normal tumor marker values. The MHV has remained patent for 24 months after its reconstruction. A resection of the liver metastases including venous reconstruction is beneficial for patients since it results in a longer survival and allows for venous drainage of the residual liver. The peritoneum is also accessible, enabling the fitting of a patch graft for hepatic vein repair.
authors.affiliation: First Department of Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: Koho
authors.initials: K
authors.lastname: Akimaru
authors.forename: Masahiko
authors.initials: M
authors.lastname: Onda
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yokomuro
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshioka
authors.forename: Sho
authors.initials: S
authors.lastname: Mineta
mesh_terms: D000368:Aged; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D010537:Peritoneum / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods; D012811:Sigmoid Neoplasms / Q000473:pathology