The role of complete hemihepatic vascular exclusion in the prevention of tumour dissemination during hepatectomy / 中华肝胆外科杂志

ABSTRACT

Objective To study the efficacy of complete hemihepatic vascular exclusion (CHVE) in the prevention of tumour dissemination during liver resection for hepatocellular carcinoma (HCC).MethodsA case-control study was carried out on 281 patients who underwent liver resection for HCC between February 2006 and April 2010.89 patients underwent hepatic resection using CHVE (group A) and 192 using Pringle maneuver (group B).The postoperative 1-,2-,3 year rates of intrahepatic recurrence and lung metastasis,and the overall disease-free survivals were compared between the two groups.ResultsThe incidence of lung metastasis at 1 year after operation was significantly lower in group A than group B (6.7％ vs.15.1％,P=0.048).There were no signilicant differences in the incidences of lung metastasis at postoperative year 2 and 3 between the two groups (15.7％ vs.25.0％ and 32.6％ vs.30.7％ ; P＞0.05).The differences in the postoperative 1-,2-,3- year intrahepatic recurrence rates were not significant between the two groups (20.2％ vs.31.8％,51.7％ vs.60.3％,68.5％ vs.79.2％,respectively; P＞0.05).The median survivals of the two groups were 25.9 months and 21.7 months,respectively.Patients in group A had a significantly higher overall disease-free survival rate than patients in group B (P=0.035).ConclusionsCHVE was efficacious in reducing the incidence of lung metastasis and in improving the overall disease-free survival in patients after liver resection for HCC.CHVE contributed in preventing intraoperative tumour dissemination and in improving prognosis.