Liver Cancer Surgery in Uberlândia-MG

In the early stages, liver cancer is usually asymptomatic. When they appear, the most common signs include discomfort or pain in the upper right abdominal quadrant, unintentional weight loss, persistent fatigue, loss of appetite, and a feeling of abdominal fullness. Jaundice (yellowing of the skin and eyes) and ascites (fluid buildup in the abdomen) generally indicate more advanced disease. Patients with cirrhosis, chronic hepatitis B or C, or a history of colorectal cancer should undergo periodic follow-up, even without symptoms.

Diagnosis combines imaging exams — abdominal ultrasound, computed tomography, and magnetic resonance imaging with liver-specific contrast — and, when indicated, measurement of the tumor marker alpha-fetoprotein. In cases of diagnostic uncertainty, an image-guided liver biopsy may be necessary. The workup also assesses overall liver function and the degree of cirrhosis, when present, information that directly influences the definition of the most appropriate treatment strategy for each case.

Duration varies according to the extent of the resection, the surgical approach (open, laparoscopic, or robotic), and the anatomical complexity of the case, ranging from about two to more than six hours. Larger resections, those near major hepatic vessels, or those combined with additional procedures tend to take longer. The exact duration can only be estimated after an individual evaluation of the patient's imaging and surgical planning.

Hepatectomy is performed under general anesthesia, with continuous monitoring and, frequently, complementary analgesia techniques to control postoperative pain. The pre-anesthetic assessment considers liver function, cardiopulmonary reserve, and other clinical conditions of the patient, and is conducted jointly by the anesthesiology team and the surgical team to define the safest plan for each case.

The length of hospital stay varies according to the extent of the resection, the surgical approach used, and the patient's clinical progress, ranging from a few days for limited laparoscopic or robotic resections to one or two weeks for larger open hepatectomies. Factors such as prior liver function, age, and the presence of comorbidities also influence hospital recovery time, which should be discussed individually.

As with any major abdominal surgery, there is pain in the immediate postoperative period, controlled with multimodal analgesia (intravenous medications and, when indicated, regional block techniques) adjusted according to the patient's response. Intensity tends to be greater in the first 48 to 72 hours and decreases progressively. In minimally invasive surgery (laparoscopic or robotic), postoperative discomfort is usually less than with the open approach.

An abdominal drain is commonly used postoperatively to monitor for fluid collections or bile leakage, and is removed once its output and characteristics indicate it is safe to do so, usually within a few days. A urinary catheter is also typically used temporarily for close monitoring of urine output in the initial period. The need for and duration of these devices vary according to each patient's clinical progress.

In the open approach, the incision is typically subcostal (below the ribs) and may extend depending on the extent of the resection, resulting in a more visible scar. In laparoscopic and robotic approaches, only small incisions are made for the instruments, resulting in smaller scars. The choice of approach depends on technical and oncologic factors, not only aesthetic ones, and should be individualized.

Return to activities depends on the extent of the surgery, the surgical approach, and the nature of the work. In general, light activities can be resumed within a few weeks after minimally invasive surgery, while larger open resections and activities requiring physical exertion usually require a longer recovery period, which can extend over several weeks. The definitive timeframe is assessed individually.

As with any major liver surgery, hepatectomy carries risks that include bleeding, biliary fistula, postoperative liver failure (related to the volume of remaining liver), infection of the surgical wound or abdominal fluid collections, in addition to general anesthetic risks. Individual risk depends on the extent of the resection, prior liver function (especially in the presence of cirrhosis), and comorbidities, and is detailed on a case-by-case basis before the surgical decision.

No. In resectable primary tumors (hepatocellular carcinoma), surgery may be the main treatment modality, without a mandatory need for chemotherapy. In liver metastases of colorectal origin, treatment usually involves neoadjuvant or adjuvant chemotherapy in combination with hepatectomy, defined by the multidisciplinary team — oncologic surgery, clinical oncology, and, when indicated, radiation therapy — according to staging, tumor biology, and response to systemic treatment.