Minerva Medica 2020 May 14

DOI: 10.23736/S0026-4806.20.06613-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

One-stage resection of primary colorectal cancer and hepatic metastases using the habib device: analysis of 40 consecutive cases treated in a unit of general surgery

Vincenzo TAMMARO ¹ ✉, Nicola CARLOMAGNO ¹, Michele SANTANGELO ¹, Armando CALOGERO ¹, Concetta A. DODARO ¹, Antonio VERNILLO ¹, Antonello SICA ², Gaia PELUSO ¹, Silvia CAMPANILE ¹, Evangelista SAGNELLI ³, Caterina SAGNELLI ³

¹ Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy; ² Department of Precision Medicine, University of Campania Campania Luigi Vanvitelli, Naples, Italy; ³ Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy

BACKGROUND: More than 50% of patients with Colorectal cancer (CRC) present or develop hepatic metastases (HM). The intraoperative use of the Habib 4X® radio frequency probe device is safe in resetting HM and allows a one-stage resection of both CRC and HM with a similar mortality rate than a two-stage surgical treatment.
METHODS: After an exhaustive residential training at the reference center for hepato-biliary surgery of the Imperial College of London, we treated at our unit of general surgery 40 consecutive patients with CRC and HM with the one-stage resection, using the Habib 4X® intraoperative radiofrequency probe device to reset HM.
RESULTS: None of the 40 patients died during the intra-operatory and post-operatory periods, none presented liver failures during the postoperative course nor complication related to the Habib’s resection procedure (e.g. bleeding, abscess, bile leak). The amount of intra-operative liver bleeding was minimal. New HM arose in 10 (25%) cases, with a mean disease-free interval of 13 months, but the hepatic tissue close to previous resections remained cancer-free. The 69.7 % of patients were disease-free at month 24 of the post-operative follow-up and 5-year rate was about 70%.
CONCLUSIONS: The data suggest that surgeons well trained at a reference center for hepato-biliary surgery may perform with excellent results the one-stage CRC and HM resection with the Habib 4X® device even in a unit of general surgery.

KEY WORDS: Colorectal cancer; Hepatic metastases; One stage resection; Habib 4x device