Liver resection is the surgical removal of all or a portion of the liver. This surgery is usually done to remove the various types of liver tumors that are located in the resected portion of the liver. The goal of liver resection is to completely remove the tumor and the appropriate surrounding liver tissues.
Harry (name changed) a 70-year-old man and a plastic surgeon by profession from Ghana, presented himself at HCG Cancer Centre, Mumbai with history of abdominal discomfort of 1-month duration. He was a known case of colon cancer treated in 2018 in his country with surgery and chemotherapy. On investigation at HCG Cancer Centre Mumbai, there was metastasis in the liver. After discussion in multidisciplinary tumor board, he was treated with 6 cycles of chemotherapy and targeted therapy at HCG Cancer Centre, Mumbai. He responded very well to chemotherapy and targeted therapy.
Since the metastasis was present only in the liver area, liver resection surgery was advised by Dr. Indoo Ambulkar, Senior Consultant- Medical Oncology, HCG Cancer Centre Mumbai andthe team to potentially cure the disease. The patient’s preoperative examinations were planned with PET CT scan, laparoscopy, blood tests, CT angiography, CT volumetric to study the size and quality of the liver along with the position of various blood vessels inside the liver. Functional Liver Remnant or FLR was also carried out to ensure that the patient doesn’t have any postop liver failure since the patient had previously undergone abdominal surgery that could cause more difficulties.
After proper assessment of the normal functioning of the liver, the doctors decided to resect the right lobe of the liver (Right Hepatectomy). A specialized equipment Thomson Retractor was used for the surgery by Dr. Nilesh, Consultant Hepatobiliary Surgeon, HCG Cancer Centre Mumbai and the team. This device helped in getting an adequate exposure of the entire tumor and a CUSA machine was used to safely divide the liver tissue without causing major bleeding. Liver resection was successfully performed on metastasis from colon cancer. There was minimal blood loss during the surgery.
A massive metastatic tumor weighing 4 kgs and 25cms on the right side of his liver, which was close to many major blood vessels was resected. It was a challenging case as the tumor was in the liver which is a vital organ, resection can be fatal also as it was a big tumor, patient was elderly (but fit), it was a second surgery (first surgery was done for colon cancer), resection was planned to do in the metastatic disease. On the third day post-surgery, the patient started taking orally and on the seventh day he was completely recovered. His histopathology reports also showed that liver resection was successful as the tumor was completely removed. A multidisciplinary team of specialists consisting of medical oncologists, surgical oncologist, pathologists, radiologists, physician and anesthesia provided optimal and supportive care to the patient. The expertise of the doctor and the technology helped in improving the quality of life and increase the survival rate for the patient. The patient can now lead a long life without any complications.