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Published on: March 10, 2023
Role of Mesohepatectomy for Pediatric Centrally Located Liver Tumors
Shajini Nirmalan1, Senthilnathan Ramaswamy1, Vivek Shanmugam1
1Department of Paediatric Surgery, Institute of Child Health, Madras Medical College, Chennai, Tamil Nadu, India.
Background:
Mesohepatectomy (MH) or central hepatectomy (CH) is a recognized surgical technique for centrally located pediatric liver tumors. This technique of liver resection avoids extended liver resections and thereby helps in the preservation of liver parenchyma. In this article, we aim to analyze our experience and outcome with this technique of liver resection.
Methods:
A retrospective analysis of patients who underwent MH from January 2015 to June 2023 at our institute was performed. The variables analyzed include demographics, preoperative treatment, perioperative management, and postoperative outcome.
Results:
A total of five patients underwent CH. Four patients had hepatoblastoma, and one patient had mesenchymal hamartoma. All four patients with hepatoblastoma received neoadjuvant chemotherapy. All five patients had negative surgical margins, and one of the five developed disease recurrences necessitating resurgery and ultimately died of metastasis. one patient sustained intraoperative major bile duct injuries, and one patient had postoperative Abnormal, well-circumscribed, extra-biliary collection of bile.
Conclusion:
MH with clear margins is feasible in the selected subset of pediatric liver tumors involving segments IV, V, and VIII with outcomes equivalent to extended hepatic resections.
Insights
Mesohepatectomy (MH), a central liver resection, effectively treats pediatric liver tumors while preserving liver tissue. This study shows MH is feasible for specific tumors, offering outcomes comparable to extensive resections.
Area of Science:
- Pediatric Surgery
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Mesohepatectomy (MH), also known as central hepatectomy (CH), is a surgical approach for centrally located pediatric liver tumors.
- This liver resection technique aims to preserve liver parenchyma by avoiding extended resections.
Purpose of the Study:
- To analyze the experience and outcomes of mesohepatectomy (MH) in pediatric liver tumor cases.
- Evaluate the feasibility and effectiveness of central hepatectomy (CH) in a pediatric cohort.
Main Methods:
- Retrospective analysis of patients who underwent MH between January 2015 and June 2023.
- Collected data included demographics, preoperative treatment, perioperative management, and postoperative outcomes.
Main Results:
- Five pediatric patients underwent CH for liver tumors (four hepatoblastoma, one mesenchymal hamartoma).
- All patients achieved negative surgical margins; one recurrence led to metastasis and death.
- Complications included one intraoperative bile duct injury and one postoperative bile collection.
Conclusions:
- Mesohepatectomy (MH) with clear margins is a viable option for selected pediatric liver tumors involving segments IV, V, and VIII.
- Outcomes of MH are comparable to those of extended hepatic resections in this patient subset.
