Extended right hepatectomy with anterior approach for infant hepatoblastoma

Abstract

Summary Background: Hepatoblastoma is the most common liver malignancy in children with the incidence about one per million children. Radical resection plays a key role in the successful treatment of children with hepatoblastoma. However, the feasibility of radical resection is relatively difficult when the tumor is huge and invades hilar structure. This video showed early extended right hepatectomy for infant huge right lobe hepatoblastoma. Methods: Preoperative CT suggested the huge mass was found in right lobe of a 28-month-old female infant. The laboratory examination showed AFP was >1210ng/ml. Three-dimensional (3D) reconstruction showed the middle hepatic vein (MHV) was obviously compressed and pushed to the left lobe. The remaining liver volume after 3D simulated surgical excision was 39.7%. According to the accurate preoperative evaluation, this patient was successfully performed with extended right hepatectomy using anterior approach. Results: Operative time was 4 hours. Blood loss was 100ml. The tumor size was 12cm*10cm*7.5cm. The pathology suggested mixed epithelial mesenchymal hepatoblastoma. The patient obtained rapid recovery and was discharged 15 days after surgery. Conclusion: According to the accurate preoperative evaluation, radical resection instead of chemotherapy was technically safe and offers potential cure for hepatoblastoma.