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Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Hepatic metastasectomy in children
Wendy T Su1, Daniel N Rutigliano, Maryam Gholizadeh
1Department of Surgery, Division of Pediatric Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Cancer
|April 6, 2007
Summary
Hepatic metastasectomy in children is feasible with low operative risks. Anatomical resection improved local control, but overall prognosis for pediatric liver metastases remains poor, necessitating selective surgical decisions.
Area of Science:
- Pediatric Surgery
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Limited data exists on the safety and efficacy of hepatic metastasectomy for pediatric solid tumors.
- Assessing operative outcomes, resection techniques, local control, and survival is crucial for this patient population.
Purpose of the Study:
- To evaluate the institutional experience with hepatic metastasectomy in children.
- To determine operative mortality, morbidity, and long-term outcomes following liver resection for pediatric metastases.
Main Methods:
- Retrospective review of pediatric patients undergoing hepatic resection for metastatic disease (August 1988 - July 2005).
- Data collection included patient demographics, primary tumor types, surgical techniques, and clinical outcomes.
Main Results:
- Fifteen pediatric patients with various primary malignancies (neuroblastoma, Wilms tumor, osteosarcoma, etc.) underwent liver resection.
- No operative or postoperative deaths occurred; complications were infrequent (wound infection, bile collection).
- Anatomical hepatic resections showed better local control than wedge resections, though overall survival was poor with high rates of disease progression and local recurrence.
Conclusions:
- Hepatic metastasectomy in children is a feasible procedure with low operative risks.
- Anatomical hepatectomy appears superior to wedge resection for local control in pediatric liver metastases.
- Despite feasibility, the poor overall prognosis mandates highly selective surgical consideration for hepatic metastasectomy in children.
