Surgical displacement of risk organs to improve stereotactic radiotherapy for liver tumors.
OBJECTIVE
Precision irradiation may cure some liver malignancies, but adjacent stomach and colon may interfere with the delivery of the desired high doses due to the risk for serious side effects.


RESULTS
Preferably laparoscopic distancing of the risk organs included their mobilization, omental interposition between them and the target, and gastropexy to the lateral abdominal wall. This enabled us to more than double the radiation doses that were permitted by native anatomy.


CONCLUSIONS
Minimally invasive surgical displacement of risk organs may increase the prospect of local control of liver tumors after precision irradiation with little demand on the patients and resources.
Gunvén
Peter
P
Department of Oncology, Radiumhemmet, Karolinska University Hospital at Solna, 17176 Stockholm, Sweden. peter.gunven@karolinska.se
Jonas
Eduard
E
Wersäll
Peter
P
Lax
Ingmar
I
D000368:Aged; D000369:Aged, 80 and over; D003106:Colon; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods*; D013270:Stomach