Mesohepatectomy as an option for the treatment of central huge hepatic carcinoma

Abstract

Objective To evaluate the indication,techniques and efficacy of mesohepatectomy for the treatment of central huge primary hepatic carcinoma.Methods From 2009 to 2013,22 cases of centrally located huge hepatic carcinoma in First Affiliated Hospital of Xian Jiaotong University were retrospectively analyzed by clinical data and follow-up statistics.Results Median diameter of tumors was 12.5 cm (range 10.5 ～22 cm).18 cases were single lesion and 4 cases were multiple lesion.Tumor combined with tumor thrombus in 6 patients.The preoperative liver function was graded as A in 16 patients and B in 6 ones.The median ICG-R15 value of patients was 5.2％ (range 0.4 ～9.1％).2 cases underwent TACE preoperatively in other hospitals and 9 cases of patients underwent postoperative adjuvant therapy.The median operation time was 265 min (range 180 ～ 490 min),and median blood loss was 850 ml (range 200 ～2 200 ml).Intraoperative blood transfusion was 650 ml(0 ～ 2 400 ml).The occlusion time of inflow tract ranged from 8 to 51 minutes,26 minutes in median.Of inferior vena cava,the value was 7 min (0 ～14 min).Postoperative complications were found in 12 patients,1 case died of hepatic failure 4 days after operation.Postoperative hospital stay was 12 days (range 8 ～ 50 days).Overall survival and disease-free survival rates of 1 ～,2 ～,3 ～ years were 81.1％,70.9％,53.2％ and 80.2％,31.2％,31.2％ respectively.Conclusion With accurate indication,operative skill and proper perioperative treatment,mesohepatectomy is an effective method for central huge hepatic carcinnoma. Key words: Huge hepatic carcinoma; Mesohepatectomy