Mesohepatectomy for treatment of centrally located liver tumors: a report of 9 cases and systematic literature review

Abstract

Objective To evaluate the safety and efficacy of mesohepatectomy for treating centrally located liver tumors. Methods The clinical data of 9 cases of centrally located liver tumor treated in our hospital with mesohepatectomy were retrospectively analyzed. Meanwhile, previous reports in Chinese and English on mesohepatectomy for treating centrally located liver tumors were reviewed.Results In the current series, perioperative mortality and morbidity rates were 0 and 66.6%, respectively. Eight patients were alive during a follow-up of 3-38 months. Twenty clinical trials were included in our systematic review. Four were retrospective non-randomized trials comparing central hepatectomy with lobar or extended hepatectomy. The surgical mortality rate of mesohepatectomy was 0% ～7. 4 %. Frequent complications were bile leakage (0. 4% ～ 18. 5 % ), pleural effusion (5. 7 % ～ 23.5 % ), ascites ( 1.9 % ～ 11.6 % ) and pneumonia ( 1.7 % ～ 12.5 % ). No differences in perioperative morbidity and early complication rate were found between the mesohepatectomy group and lobar or extended hepatectomy group in all four non-randomized studies. Two studies revealed that the overall survival rate and disease-free survival of patients with hepatocellular carcinoma were similar between the 2 groups. Conclusion Mesohepatectomy is a safe and effective operative procedure for the treatment of centrally located liver tumors. Key words: Liver neoplasms; Mesohepatectomy; Centrality