Mesohepatectomy

• Published in: The American journal of surgery 2000-05, Vol.179 (5), p.356-360
• Main Authors: Scudamore, Charles H, Buczkowski, Andrzej K, Shayan, Hossein, Ho, Stephen G.F, Legiehn, Gerald M, Chung, Stephen W, Owen, David A
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Biological and medical sciences; Biopsy; Blood Loss, Surgical - statistics & numerical data; Carcinoma, Hepatocellular - classification; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - surgery; Dissection; Dissection - methods; Gallbladder; Gallbladder cancer; Gastroenterology. Liver. Pancreas. Abdomen; Hepatectomy; Hepatectomy - adverse effects; Hepatectomy - methods; Hepatectomy - trends; Hepatitis; Hepatocellular carcinoma; Humans; Length of Stay - statistics & numerical data; Liver; Liver cancer; Liver cirrhosis; Liver Neoplasms - classification; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Malignancy; Medical sciences; Metastases; Metastasis; Middle Aged; Morbidity; Mortality; Occlusion; Patient Selection; Patients; Retrospective Studies; Segments; Severity of Illness Index; Surgeons; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Terminology as Topic; Thoracic surgery; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Tumors; Ultrasonic imaging; Variance analysis; Veins & arteries
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(00)00374-3

Background: Formal anatomic (lobar) or extended hepatectomies are recommended for liver malignancies located centrally within the liver (Couinaud’s segments IVA, IVB, V, and VIII). Mesohepatectomy, resection of central hepatic segments and leaving the right and left segments in situ, removes large central tumors preserving more functioning liver tissue than either extended left or right hepatectomy. Mesohepatectomy is a seldom used, technically demanding procedure, and its application is yet to be defined. Methods: Medical charts of 244 consecutive liver resection patients were reviewed retrospectively. Eighteen patients were treated with mesohepatectomy. Six patients had metastatic liver tumor (MLT), 11 had hepatocellular carcinoma (HCC), and 1 had gallbladder adenocarcinoma. The operative results were compared with groups of patients treated by lobar hepatectomy (n = 71) and extended left or right hepatectomy (n = 43). Results: The mean mesohepatectomy operative time was 238 versus 304 minutes in the extended group. Inflow occlusion mean time was longer in the mesohepatectomy group than in extended procedures, 45 versus 39 minutes ( P = not significant). Comparing the extended hepatectomy group, the mesohepatectomy group had a mean operative estimated blood loss 914 cc versus 1628 cc ( P