title: Reresection of Colorectal Liver Metastasis with Vena Cava Resection.
abstract: The best known treatment of the colorectal liver metastasis is the complete surgical excision with clean surgical margins. However, liver resections sometimes cannot appear technically feasible due to the high number of metastases in the liver, in cases of recurrent resections or invasion of the tumors to the major vascular structures or neighboring organs. Here, we presented a colorectal recurrent liver metastasis invading the retrohepatic vena cava, right adrenal gland, and right diaphragm. En masse resection of the tumor with caudate hepatectomy combined with vena cava resection and surrounding adrenal and diaphragm resections was accomplished. Caval reconstruction was done by a 5 cm in length cryopreserved vena cava homograft under isolated caval clamping. Postoperative period was uneventful and she was discharged on day 11. As a conclusion, combined liver and vena cava resection for a recurrent colorectal liver metastasis is a feasible procedure even with additional neighboring organ resections. Isolated vena cava occlusion with the preservation of the hepatic blood flow may decrease the risk of liver injury in case of previous chemotherapy for liver metastasis.
authors.affiliation: Department of Surgery, Inonu University, 44100 Malatya, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Tardu
authors.affiliation: Department of Surgery, Inonu University, 44100 Malatya, Turkey.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Kayaalp
authors.affiliation: Department of Surgery, Inonu University, 44100 Malatya, Turkey.
authors.forename: Sezai
authors.initials: S
authors.lastname: Yilmaz
authors.affiliation: Department of Surgery, Inonu University, 44100 Malatya, Turkey.
authors.forename: Kerem
authors.initials: K
authors.lastname: Tolan
authors.affiliation: Department of Surgery, Inonu University, 44100 Malatya, Turkey.
authors.forename: Veysel
authors.initials: V
authors.lastname: Ersan
authors.affiliation: Department of Surgery, Inonu University, 44100 Malatya, Turkey.
authors.forename: Servet
authors.initials: S
authors.lastname: Karagul
authors.affiliation: Department of Surgery, Inonu University, 44100 Malatya, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Ertuğrul
authors.affiliation: Department of Surgery, Inonu University, 44100 Malatya, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Kirmizi