Minimizing the risk of small-for-size syndrome after liver surgery

Author(s) Papamichail M. (mp1977gr@googlemail.com); M P.; ND H.; Pizanias M.; Heaton N.D.
Institution(s) (Papamichail, M, M, ND) Department of Hepato-Pancreato-Biliary Surgery, Royal Blackburn Hospital, Blackburn, UK BB2 3HH, United Kingdom
(Pizanias, M, M, ND) Department of General Surgery, Whittington Hospital, London, UK N19 5NF, United Kingdom
(Heaton, M, M, ND) Department of Liver Transplant and Hepato-Pancreato-Biliary Surgery, Institute of Liver Studies, Kings Health Partners at King's College Hospital NHS Trust, London, UK SE5 9RS, United Kingdom
Source Hepatobiliary and Pancreatic Diseases International; 2021
Publication Type(s) Review
Database EMBASE
AbstractBackground: Primary and secondary liver tumors are not always amenable to resection due to location and size. Inadequate future liver remnant (FLR) may prevent patients from having a curative resection or may result in increased postoperative morbidity and mortality from complications related to small-for-size syndrome (SFSS). Data sources: This comprehensive review analyzed the principles, mechanism and risk factors associated with SFSS and presented current available options in the evaluation of FLR when planning liver surgery. In addition, it provided a detailed description of specific modalities that can be used before, during or after surgery, in order to optimize the conditions for a safe resection and minimize the risk of SFSS. Result(s): Several methods which aim to reduce tumor burden, preserve healthy liver parenchyma, induce hypertrophy of FLR or prevent postoperative complications help minimize the risk of SFSS. Conclusion(s): With those techniques the indications of radical treatment for patients with liver tumors have significantly expanded. The successful outcome depends on appropriate patient selection, the individualization and modification of interventions and the right timing of surgery.Copyright © 2021

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