부산대학교 도서관

Simple Summary: Liver tumours in children are definitely "surgical tumours", and their complete resection is essential for cure. Compared to adults, the extent of resection in children can be much greater; up to 75–85% of the liver parenchyma can be safely resected. However, parenchymal preservation resection (segmentectomy, bisegmentectomy) seems to be a good option in carefully selected patients. There are very few publications regarding minor liver resections in children. From the available literature and data presented here, we propose that (bi)segmentectomy can become a viable surgical option in patients with favourable tumour locations and the absence of portal invasion in imaging. But, when qualifying a child for minor resection, it is important to remember that meeting oncological goals remains the primary objective of liver surgery. Further studies evaluating the impact of parenchymal preservation surgery on surgical and oncological outcome after liver resection in children should be conducted with a larger dataset. Purpose: To present a single-centre experience in bi- and uni-segmentectomies for primary liver tumours in children. Methods: This study included 23 patients that underwent (bi)segmentectomy. There were 15 malignant tumours (hepatoblastoma—13 patients), 7 benign tumours, and 1 calcifying nested stromal epithelial tumour. Results: The median tumour diameter was 52 mm (range 15–170 mm). Bisegmentectomy 2–3 was most frequently performed (seven patients), followed by bisegmentectomy 5–6 (four patients). The median operative time was 225 min (range 95–643 min). Intraoperative complications occurred in two patients—small bowel perforation in one and an injury of the small peripheral bile duct resulting in biloma in the other. The median resection margin in patients with hepatoblastoma was 3 mm (range 1–15 mm). Microscopically negative margin status was achieved in 12 out of 13 patients. There were two recurrences. After a median follow-up time of 38 months (range 12–144 months), all 13 patients with HB were alive with no evidence of disease. Two relapsed patients were alive with no evidence of disease. Conclusions: From the available literature and data presented here, we propose that (bi)segmentectomy can become a viable surgical option in carefully selected paediatric patients and is sufficient to achieve a cure. Further studies evaluating the impact of parenchymal preservation surgery on surgical and oncological outcome should be conducted with a larger dataset. [ABSTRACT FROM AUTHOR]