Digital Public Defence: Leonid Barkhatov
MD Leonid Barkhatov at Institute of Clinical Medicine will be defending the thesis “Modern trends in surgical treatment of colorectal liver metastases: From laparoscopic parenchyma-sparing resection to focused ultrasound ablation” for the degree of PhD (Philosophiae Doctor).
The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Digital Trial Lecture – time and place
- First opponent: Senior Consultant Ruslan Alikhanov, Moscow Clinical Scientific Center, Russia
- Second opponent: Senior Consultant Gregor Alexander Stavrou, Klinikum Saarbrücken, Germany
- Third member and chair of the evaluation committee: Professor Heidi Beate Eggesbø, University of Oslo
Chair of the Defence
Professor Emeritus Trond Buanes, University of Oslo
Professor II Bjørn von Gohren Edwin, University of Oslo
Surgical treatment of colorectal liver metastases has seen a rapid development in the last few decades. From the initial preference for major surgeries, a trend towards minimally- invasive parenchyma-preserving techniques emerged as the surgical instruments evolved together with diagnostic tools and surgical skills. An appreciation of the advantages that minimally invasive surgeries entail both for the patient and the institution has spurred the evolution of this surgical technique.
The aim of this thesis is to illuminate the subject of surgical treatment of colorectal liver metastases and to present the most important aspects that influence the decision making process when considering the treatment algorithm of a patient.
We contemplate the practical aspects of implementation of novel methods in treatment of colorectal liver metastases, and its impact on the short- and long-terms outcomes. This considered, we turn our attention to the inevitable question of whether the feasible laparoscopic parenchyma-sparing procedure is also advantageous for the patient in terms of survival and extended indications for surgery. Further, we describe a novel treatment using MR-guided high-intensity focused ultrasound ablation (MRgHIFU) that has been approved in porcine model for difficult locations close to large hepatic vessels. These locations are some of the most challenging in liver surgery and are often a cause of inoperability.
We found that laparoscopic parenchyma-sparing resections give satisfactory short- and long-term outcomes, even in difficult locations such as postero-superior segments of the liver. Maximum preservation of parenchyma allows the surgeon to perform redo resections, with continuously respectable survival even after the fourth subsequent operation for recurrences. Despite the fact that the technique is challenging and requires a prolonged period of apprenticeship, the learning curve is safe in the hands of an experienced liver surgeon or with guidance of experienced mentor. Experimental study demonstrates that performing ablations close to large hepatic vessels is feasible while using MRgHIFU.
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