Mesohepatectomy for the treatment of patients with centrally located hepatocellular carcinoma

Zuo,Chao‑Hui; Qiu,Xiao‑Xin; Ouyang,Yong‑Zhong; Zhang,Di; Xiao,Hua; Mo,Sheng‑Chuan; Tan,Chun‑Qi; Tang,Ming; Zhu,Hai‑Zhen

doi:10.3892/mco.2014.309

Mesohepatectomy for the treatment of patients with centrally located hepatocellular carcinoma

Authors:
- Chao‑Hui Zuo
- Xiao‑Xin Qiu
- Yong‑Zhong Ouyang
- Di Zhang
- Hua Xiao
- Sheng‑Chuan Mo
- Chun‑Qi Tan
- Ming Tang
- Hai‑Zhen Zhu
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Affiliations: Department of Gastroduodenal and Pancreatic Surgery, Hunan Provincial Tumor Hospital and Affiliated Tumor Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, P.R. China, Liver Cancer Translational Medicine Center of Hunan University and Hunan Provincial Tumor Hospital, Changsha, Hunan 410082, P.R. China
Published online on: June 6, 2014 https://doi.org/10.3892/mco.2014.309
Pages: 833-838

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Abstract

Mesohepatectomy is considered a feasible option for patients with centrally located hepatocellular carcinoma (HCC). However, mesohepatectomy is a technically demanding and less frequently used procedure. In this study, we summarized the surgical experience and evaluated the clinical outcomes of mesohepatectomy in 24 patients with centrally located HCC. Of these patients, 9 were treated with hepatectomy of Couinaud's segments IV, V and VIII with concurrent cholecystectomy; 8 underwent resection of segments IVb, V and VIII, including 7 patients who also received a cholecystectomy; 4 underwent hepatectomy of segments IVa, V and VIII; and 3 patients were treated with hepatectomy of segments I, IV, V and VIII, with concurrent cholecystectomy. The Pringle maneuver was used on 17 patients during hepatectomy. Total hepatic vascular exclusion (HVE) was performed on 3 patients and HVE was not used on 4 patients. The average mesohepatectomy operative time was 238 min and the average intraoperative blood loss was 480 ml (200‑2,200 ml). There was no intraoperative mortality and the postoperative morbidity rate was 25% (6/24). The 1‑ and 3‑year overall survival rates were 76 and 46%, respectively. Therefore, mesohepatectomy is a safe and effective surgical procedure for the treatment of centrally located HCC and HVE during mesohepatectomy for centrally located HCC is crucial to the success of the operation and postoperative patient recovery.

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