Robot-assisted laparoscopic hepatectomy for hepatocellular carcinoma with Fontan-associated liver disease: a world-first case report.

IF 0.7 Q4 SURGERY Surgical Case Reports Pub Date : 2024-09-09 DOI:10.1186/s40792-024-02014-5

Takuma Ishikawa, Shinji Itoh, Takeo Toshima, Shohei Yoshiya, Yuki Bekki, Norifumi Iseda, Yuriko Tsutsui, Ichiro Sakamoto, Kotaro Abe, Tomoharu Yoshizumi

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Abstract

Background: Fontan-associated liver disease (FALD) encompasses hepatic complications following the Fontan procedure, ranging from fibrosis to hepatocellular carcinoma (HCC). Despite advancements in surgical techniques and perioperative care, robot-assisted laparoscopic hepatectomy (RALH) for HCC in patients with FALD has not been previously reported owing to concerns about the Fontan circulation.

Case presentation: We present the first case of RALH for recurrent HCC in a 45-year-old man after the Fontan procedure. The preoperative evaluation confirmed good cardiac function. The procedure involved meticulous monitoring and management of central venous pressure and was successfully completed with minimal blood loss. Postoperative recovery was uneventful. With thorough preoperative cardiac assessment and close collaboration between cardiologists and anesthesiologists, RALH can be safely performed in selected patients with FALD.

Conclusions: Even if a patient has a history of FALD, RALH can be safely performed in selected patients under appropriate conditions.

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机器人辅助腹腔镜肝切除术治疗伴有丰坦相关性肝病的肝细胞癌：世界首例报告。

背景：丰坦相关肝病（FALD）包括丰坦手术后的肝脏并发症，从肝纤维化到肝细胞癌（HCC）。尽管手术技术和围手术期护理取得了进步，但由于对丰坦循环的担忧，以前还没有报道过用机器人辅助腹腔镜肝切除术（RALH）治疗FALD患者的HCC：我们介绍了首例在丰坦手术后对一名45岁男性进行RALH治疗复发性HCC的病例。术前评估证实患者心功能良好。手术过程中对中心静脉压进行了细致的监测和管理，并在失血量极少的情况下顺利完成。术后恢复顺利。通过全面的术前心脏评估以及心脏科医生和麻醉科医生之间的密切合作，RALH可以安全地为选定的FALD患者实施：结论：即使患者有 FALD 病史，在适当的条件下，RALH 也可以安全地为选定的患者实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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