Mesohepatectomy for treatment of central liver tumors / 中华肝胆外科杂志

ABSTRACT

Objective To summarize the initial experience in application of mesohepatectomy for the treatment of central liver tumors while focusing on its indication, short-term and long-term prognosis and especially outlining its technical details. Methods The clinical data of 3 patients receiving mesohepatectomy from December 2007 to March 2009 in our hospital were retrospectively analyzed.The imaging characteristics were summarized to convey the indication details. The technique details of the operation were outlined so as to reduce blood loss or other complications during and after the operation. The post-operative course and follow-up data were also collected and analyzed. Results Two patients suffered from primary hepatocellular carcinoma with liver cirrhosis and the other from giant hemangioma. The tumors were located in Couinaud yegment Ⅳ and/or Ⅷ. The average blood loss and operative duration were 800 ml and 7 h, respectively. Blood liver function tests returned to normal within 7 days postoperatively and the patients were discharged after that. No complications occurred. The follow-up for 7-15 months showed that there was no recurrence. Conclusion Mesohepatectomy is the principal choice of treatment for centrally located liver tumors. For the safety and avoidance of complications, the doctor should abide by the concept of segment-oriented hepatectomy and apply the updated techniques such as CUSA (Cavitron ultrasonic surgical aspirator). For patients with compromised liver function, mesohepatectomy might be superior to extended bepatectomy. Thus, the application of mesohepatectomy should be expanded. Meanwhile, further investigation is needed for its full evaluation.