Central segments liver resection for pediatric tumors

Abstract

Aim. To analyze the short-term outcomes of сentral segments liver resection in children, according to the initial experience.Мethods. The data of patients with different centrally located liver neoplasms were analyzed. This retrospective study included three patients with hepatoblastoma, one observation of mesenchymal hamartoma of the liver and one patient with hepatocellular carcinoma. Different types of central liver resections were carried out in these patients between March and October 2018. The technical aspects and the short-term results are described.Results. Median age of patients was 78 months (9 months – 12 years). Patients underwent: segmentectomy 4b, bisegmentectomy 4b, 5, threesegmentectomy 4, 5, 6, mesohepatectomy (anatomical segmentectomy 4, 5, 8) with biliary reconstruction for posterior liver segments, mesohepatectomy with anatomical segmentectomy 6 and atypical S2, 3 resection. Dindo–Clavien grade IIIa postoperative complication developed in one patient. Vascular complications and posthepatectomy liver failure were absent. The hospital stay ranged between 9 to 14 days. The median follow-up period came to 8 months (7–14 months). The overall and event free survival at the time of writing is 100%.Conclusion. Resections of central liver segments in children are feasible and should be carried out in experiences in liver surgery centers.

The comparison of central hepatic segments resection versus extended hepatectomies outcomes in children with liver tumors

“…Анатомические границы резекции печени проходили через проекции портальных фиссур: в проекции правой портальной фиссуры при расширенной левосторонней гемигепатэктомии (РЛГГЭ) или через умбиликальную фиссуру при расширенной правосторонней гемигепатэктомии (РПГГЭ). При ЦРП границами резекции в вертикальной плоскости были портальные фиссуры, а в горизонтальной -плоскость, проведенная через портальные ворота печени [13].…”