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David A. Brown, MD; Rodney F. Pommier, MD; Eugene A. Woltering, MD; William S. Fletcher, MD

Arch Surg. 1988;123(9):1063-1066.

Abstract
• The techniques for resection of hepatic tumors have traditionally been based on lobar anatomy. The morbidity and mortality associated with hepatic resection have been most closely correlated with intraoperative blood loss. The results of 37 hepatic resections for secondary neoplasms were retrospectively reviewed. This group included 18 patients who underwent anatomic resections and 19 patients who underwent nonanatomic resections. The nonanatomic group experienced significantly less blood loss, shorter operating times, shorter hospital stays, and no significant difference In long-term survival. A positive relationship between blood loss and postoperative complications is demonstrated for the combined groups. These results support the use of nonanatomic resection whenever feasible for secondary hepatic tumors. We describe the technique for nonanatomic hepatic resection for metastatic lesions, with special emphasis on hemostatic techniques.

(Arch Surg 1988;123:1063-1066)

Author Affiliations
From the Department of Surgery, Division of Surgical Oncology, Oregon Health Sciences University, Portland. Dr Pommier is a Clinical Fellow of the American Cancer Society.

Footnotes
Accepted for publication May 9, 1988.

Read before the 59th Annual Meeting of the Pacific Coast Surgical Association, San Francisco, Feb 24, 1988.

Reprint requests to the Division of Surgical Oncology L-224A, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201 (Dr Fletcher).

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