{"title":"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。","authors":"Takuma Ishikawa, Shinji Itoh, Takeo Toshima, Shohei Yoshiya, Yuki Bekki, Norifumi Iseda, Yuriko Tsutsui, Ichiro Sakamoto, Kotaro Abe, Tomoharu Yoshizumi","doi":"10.1186/s40792-024-02014-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusions: </strong>Even if a patient has a history of FALD, RALH can be safely performed in selected patients under appropriate conditions.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Robot-assisted laparoscopic hepatectomy for hepatocellular carcinoma with Fontan-associated liver disease: a world-first case report.\",\"authors\":\"Takuma Ishikawa, Shinji Itoh, Takeo Toshima, Shohei Yoshiya, Yuki Bekki, Norifumi Iseda, Yuriko Tsutsui, Ichiro Sakamoto, Kotaro Abe, Tomoharu Yoshizumi\",\"doi\":\"10.1186/s40792-024-02014-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusions: </strong>Even if a patient has a history of FALD, RALH can be safely performed in selected patients under appropriate conditions.</p>\",\"PeriodicalId\":22096,\"journal\":{\"name\":\"Surgical Case Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2024-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgical Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s40792-024-02014-5\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40792-024-02014-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
Robot-assisted laparoscopic hepatectomy for hepatocellular carcinoma with Fontan-associated liver disease: a world-first case report.
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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