title: Bisegmentectomy 7-8 as alternative to more extensive liver resections.
abstract: BACKGROUND
  Preservation of hepatic parenchyma should be attempted whenever possible in order to reduce the risk of liver failure and increase the chance to re-resect the recurrence.
  
  
  METHODS
  The presence of a lesion in segments 7-8 infiltrating the right hepatic vein is usually an indication for right hepatectomy. If a thick inferior right hepatic vein is seen, a bisegmentectomy 7-8 can be performed. We review our experience with this uncommon liver resection.
  
  
  RESULTS
  In 11 of 332 patients with colorectal liver metastases, a lesion was localized in segments 7-8 infiltrating the right hepatic vein. Six underwent resection of segments 7-8. The mean estimated rate of remnant liver volume (segments 2-4 plus caudate lobe) was 23.7%; 4 patients had neoadjuvant chemotherapy. Intraoperative mean blood loss was 200 mL without transfusions; no patients developed postoperative liver failure, and there was no in-hospital mortality. Surgical margin was negative in all patients. Median survival was 25 months, with 3 patients alive and disease-free. One patient with an intrahepatic recurrence underwent re-resection.
  
  
  CONCLUSIONS
  Bisegmentectomy 7-8 is an uncommon but safe procedure that allows curative resections without unnecessary sacrifice of functional parenchyma.
authors.affiliation: Department of Surgical Oncology, Istituto per la Ricerca e la Cura del Cancro, 10060 Candiolo (TO), Italy. andrea.muratore@ircc.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Muratore
authors.forename: Pietro
authors.initials: P
authors.lastname: Conti
authors.forename: Marco
authors.initials: M
authors.lastname: Amisano
authors.forename: Hedayat
authors.initials: H
authors.lastname: Bouzari
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Capussotti
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications; D015996:Survival Rate