{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:24:32Z","timestamp":1785525872499,"version":"3.56.0"},"reference-count":17,"publisher":"Akademiai Kiado Zrt.","issue":"36","license":[{"start":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:00:00Z","timestamp":1725753600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2024,9,8]]},"abstract":"<jats:p>A m\u00e1jdaganatok reszek\u00e1lhat\u00f3s\u00e1g\u00e1nak felt\u00e9tele a m\u0171t\u00e9t ut\u00e1n megmarad\u00f3, megfelel\u0151\n                    m\u00e1jm\u0171k\u00f6d\u00e9st biztos\u00edtani k\u00e9pes el\u00e9gs\u00e9ges m\u00e1jsz\u00f6vetmennyis\u00e9g. Ennek m\u00e9rete a m\u0171t\u00e9t\n                    el\u0151tt k\u00fcl\u00f6nb\u00f6z\u0151 elj\u00e1r\u00e1sokkal n\u00f6velhet\u0151 meg. A vena (v.) portae occlusi\u00f3s\n                    technik\u00e1kkal lassabb \u00e9s csek\u00e9lyebb n\u00f6veked\u00e9s \u00e9rhet\u0151 el, kis rizik\u00f3j\u00fa intervenci\u00f3\n                    sor\u00e1n. Amennyiben a hypertrophia nem elegend\u0151, illetve ha felmer\u00fcl a gyors\n                    tumorpogresszi\u00f3 lehet\u0151s\u00e9ge, \u00fagy alkalmazhat\u00f3 a v. portae egyoldali elz\u00e1r\u00e1sa \u00e9s a\n                    m\u00e1j\u00e1llom\u00e1ny kett\u00e9v\u00e1laszt\u00e1sa, ami r\u00f6vid id\u0151 alatt a legjelent\u0151sebb induk\u00e1lt\n                    hypertrophi\u00e1t biztos\u00edtja. A kombin\u00e1lt m\u0171t\u00e9t morbidit\u00e1sa azonban viszonylag\n                    jelent\u0151s. A fenti technik\u00e1k el\u0151nyeit hivatott \u00f6tv\u00f6zni a m\u00e1j kett\u0151s v\u00e9n\u00e1s\n                    elsorvaszt\u00e1sa, melynek sor\u00e1n az azonos oldali v. portae \u00e9s v. hepatica\n                    occlusi\u00f3ja t\u00f6rt\u00e9nik. Ezzel gyors, az ut\u00f3bbi m\u00f3dszert megk\u00f6zel\u00edt\u0151 m\u00e9rt\u00e9k\u0171\n                    ellenoldali lebeny-hypertrophia \u00e9rhet\u0151 el biztons\u00e1gosan. Eset\u00fcnk\u00f6n kereszt\u00fcl ezt\n                    a m\u00e1jhipertrofiz\u00e1l\u00f3 technik\u00e1t mutatjuk be. A 75 \u00e9ves n\u0151beteg bizonytalan hasi\n                    panaszai miatt indult kivizsg\u00e1l\u00e1sa sor\u00e1n a m\u00e1j jobb lebeny\u00e9ben, a k\u00f6z\u00e9ps\u0151\n                    szektort is \u00e9rint\u0151, nagy m\u00e9ret\u0171 intrahepaticus cholangiocellularis tumor\n                    igazol\u00f3dott. Tekintettel a lokaliz\u00e1ci\u00f3ra, a tumor csak jobb oldali\n                    trisegmentectomi\u00e1val volt elt\u00e1vol\u00edthat\u00f3. M\u00e1jvolumetri\u00e1t v\u00e9gezt\u00fcnk, mely alapj\u00e1n\n                    a megmarad\u00f3 m\u00e1j volumene (S1-2-3) 35% alattinak bizonyult. Kett\u0151s v\u00e9n\u00e1s\n                    depriv\u00e1ci\u00f3 mellett d\u00f6nt\u00f6tt\u00fcnk. A jobb v. portae \u00e9s v. hepatica dextra\n                    occlusi\u00f3j\u00e1t k\u00f6vet\u0151 7. napon jelent\u0151s hypertrophi\u00e1t (41%) igazoltunk. A tervezett\n                    m\u0171t\u00e9tet sikeresen elv\u00e9gezt\u00fck. A posztoperat\u00edv szakban enyhe ascites csorg\u00e1s\u00e1t\n                    konzervat\u00edvan kezelt\u00fck, egy\u00e9b sz\u00f6v\u0151dm\u00e9ny nem jelentkezett, a 8. posztoperat\u00edv\n                    napon emitt\u00e1ltuk a beteget. Amennyiben a tervezett m\u00e1jreszekci\u00f3 kapcs\u00e1n a\n                    megmarad\u00f3 m\u00e1j v\u00e1rhat\u00f3 t\u00e9rfogata nem el\u00e9gs\u00e9ges, m\u00e1jregener\u00e1ci\u00f3s technik\u00e1k\n                    alkalmaz\u00e1s\u00e1ra van sz\u00fcks\u00e9g. Az el\u00e9rhet\u0151 technik\u00e1k k\u00f6z\u00fcl a leg\u00fajabb, alacsony\n                    sz\u00f6v\u0151dm\u00e9nyrizik\u00f3val kecseget\u0151 megold\u00e1s a kett\u0151s v\u00e9n\u00e1s depriv\u00e1ci\u00f3, mely sor\u00e1n az\n                    azonos oldali v. portae \u00e9s v. hepatica elz\u00e1r\u00e1s\u00e1ra ker\u00fcl sor. A fenti eset\n                    bizony\u00edtja, hogy a m\u00f3dszert\u0151l gyors \u00e9s hat\u00e9kony m\u00e1jregener\u00e1ci\u00f3 v\u00e1rhat\u00f3 minim\u00e1lis\n                    megterhel\u00e9ssel, ami lehet\u0151v\u00e9 teszi a biztons\u00e1gos kiterjesztett m\u00e1jreszekci\u00f3k\n                    elv\u00e9gz\u00e9s\u00e9t. Orv Hetil. 2024; 165(36): 1433\u20131439.<\/jats:p>","DOI":"10.1556\/650.2024.33122","type":"journal-article","created":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T10:39:45Z","timestamp":1725791985000},"page":"1433-1439","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":2,"title":["\u00daj m\u00f3dszer a m\u00e1jregener\u00e1ci\u00f3 fokoz\u00e1s\u00e1ra: a m\u00e1j kett\u0151s v\u00e9n\u00e1s sorvaszt\u00e1sa"],"prefix":"10.1556","volume":"165","author":[{"given":"B\u00e1lint","family":"Kokas","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyula","family":"Krizs\u00e1ny","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damj\u00e1n","family":"Pekli","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Meltzer","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e1vid","family":"B\u00e1rdos","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, 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Consensus Conference,\n                    Budapest, April 24, 2021. [A hepatocellularis carcinoma komplex kezel\u00e9se.\n                    Konszenzuskonferencia, Budapest, 2021. \u00e1prilis 24.] Orv Hetil. 2021; 162(Suppl\n                    2): 2\u201331."},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Madoff DC, Abdalla EK,Vauthey JN. Portal vein embolization in\n                    preparation for major hepatic resection: evolution of a new standard of care. J\n                    Vasc Interv Radiol. 2005; 16: 779\u2013790.","DOI":"10.1097\/01.RVI.0000159543.28222.73"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Hahn O, B\u00e1rdos D, Kupcsulik P, et al. Decreasing morbidity after\n                    Associating Liver Partition and Portal vein ligation for Staged hepatectomy\n                    (ALPPS) with technical modification and patient selection. 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Study protocol of the\n                    HYPER-LIV01 trial: a multicenter phase II, prospective and randomized study\n                    comparing simultaneous portal and hepatic vein embolization to portal vein\n                    embolization for hypertrophy of the future liver remnant before major\n                    hepatectomy for colorectal liver metastases. BMC Cancer 2020; 20:\n                    574.","DOI":"10.1186\/s12885-020-07065-z"},{"key":"R12","unstructured":"Korenblik R, van Zon J, Olij B, et al. Resectability of bilobar\n                    liver tumours after simultaneous portal and hepatic vein embolization versus\n                    portal vein embolization alone: meta-analysis. BJS Open 2022; 6:\n                    zrac141."},{"key":"R13","unstructured":"Shen YH, Yue AM, Ju AD, et al. Application of liver venous\n                    deprivation in secondary hepatic resection of primary liver cancer. 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