Yang Wei,Ren Qinghua,Qin Hong,et al.Evaluations of precise hepatectomy for pediatric hepatoblastoma[J].Journal of Clinical Pediatric Surgery,,19():392-397.[doi:10.3969/j.issn.1671-6353.2020.05.004]
Evaluations of precise hepatectomy for pediatric hepatoblastoma
- Keywords:
- Liver Neoplasms; Surgical Procedures; Operative; Postoperative Complications; Therapy; Prognosis
- CLC:
- R735.7;R726.1
- Abstract:
- Objective To evaluate the outcomes of precision hepatectomy for pediatric hepatoblastoma (HB) and explore its choice of surgical approaches.Methods From June 2014 to May 2019,a total of 134 HB children undergoing precision hepatectomy were selected.Tumor stage,risk grade,tumor growth site,tumor size,preoperative chemotherapy,operative duration,intraoperative blood loss,postoperative serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were collected retrospectively.And the relevant parameters of postoperative complications,duration of abdominal drainage tube,postoperative hospital stay and long-term survival status were compared with those of HB counterparts undergoing standard hepatectomy in the same period and the therapeutic outcomes were evaluated.Results The procedures were precision hepatectomy (n=88,65.7%) and standard hepatectomy (n=46,34.3%).Based upon different resection approaches,they were divided into precision and standard hepatectomy groups.Intraoperative blood loss,postoperative levels of ALT & AST and postoperative duration of drainage tube were lower in precision hepatectomy group than those in regular hepatectomy group.In terms of long-term prognosis,no significant inter-group difference existed in 2-year events-free survival (EFS) or 2-year overall survival (OS).After stratified correction with RETEXT stage (pretreatment extension stage),2-year OS of patients with PRETEXT Ⅲ stage in precision hepatectomy group was higher than that in regular hepatectomy group.Conclusion For HB children,accurate hepatectomy after individualized evaluations can completely remove tumor foci,reduce operative insults and minimize the occurrence rate of postoperative complications for an optimal prognosis.
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Memo
收稿日期:2020-03-06。
基金项目:中国工程院咨询研究课题(编号:2019-XY-34)
通讯作者:王焕民,Email:wanghuanmin@bch.com.cn