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Many patients are candidates for surgical
removal (resection) of their liver tumors,
which is the treatment approach associated
with the highest chance for cure. Liver resections
are generally considered complex surgery and
published data have consistently demonstrated
that hospitals and centers with the highest
liver surgery volume experience the lowest
complication and death rates. Surgeons in
the Divisions of Surgical Oncology and Transplant
Surgery perform the vast majority of liver
resections at the Massachusetts General Hospital.
New techniques used to minimize blood loss
during surgery including use of radiofrequency
energy during dissection, use of ultrasonic
dissection, and use of surgical staplers
have reduced the instances in which blood
transfusions are required. The median
hospital stay following major liver resection
has been reduced to seven days as a result
of many of these advances. For patients
with unresectable liver tumors, surgical
treatment options include liver transplantation,
radiofrequency ablation, ethanol injection,
chemoembolization, and insertion of hepatic
arterial infusion pumps. (More information
on hepatic arterial infusion chemotherapy
can be obtained from Medtronic and from
MGH Surgical Oncology.) This team of surgeons
is also poised to launch a new clinical
trial involving hyperthermic isolated
perfusion of the liver with Melphalan
as an extension of a clinical trial in
the Surgery Branch at the National Cancer
Institute. The team is also developing
gene therapies for unresectable liver
tumors, and is poised to launch a clinical
trial of Herpes simplex viral treatment
of liver tumors. The development of living-related
liver transplant program by Dr. Cosimi
and Dr. Hertl have enabled this team to
offer liver transplantation to suitable
patients in a more timely fashion and
avoid relatively long wait times associated
with cadaveric organs. This team has worked
also together with colleagues in radiology
to develop the most sensitive tests for
detection of liver tumors, as well as
tests that allow precise mapping of liver
volumes for operative planning. This team
of surgeons is also experienced in performance
of intraoperative ultrasound examination
of the liver, which has been demonstrated
to be the most sensitive method for detection
of liver tumors.
Kenneth K. Tanabe, MD
Associate Professor of Surgery, Harvard Medical
School
Chief, Division of Surgical Oncology, Massachusetts
General Hospital
Deputy Clinical Director, MGH Cancer Center
James C. Cusack, MD
Assistant Professor of Surgery, Harvard
Medical School
Surgical Director, Tucker Gosnell Center
for Gastrointestinal Cancers
A. Benedict Cosimi, MD
Professor of Surgery, Harvard Medical
School
Chief, Division of Transplantation Surgery
Martin Hertl, MD
Assistant Professor of Surgery, Harvard
Medical School
If you feel that you may be a candidate
for liver surgery, please contact:
Kenneth Tanabe, MD at 617-724-3868
James C. Cusack, MD at 617-724-4093
A. Benedict Cosimi, MD at 617--726-8256
Martin Hertl, MD at 617-724-3730
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