Purpose: To presenta 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.
目的：介绍单中心对儿童原发性肝脏肿瘤实施双肝段及单肝段切除术的经验。方法：本研究纳入23例接受（双）肝段切除术的患者。其中恶性肿瘤15例（肝母细胞瘤13例），良性肿瘤7例，钙化性巢状间质上皮肿瘤1例。结果：肿瘤中位直径为52毫米（范围15-170毫米）。最常实施的是2-3双肝段切除术（7例），其次是5-6双肝段切除术（4例）。中位手术时间为225分钟（范围95-643分钟）。术中并发症发生2例——1例为小肠穿孔，另1例为外周小胆管损伤导致胆汁瘤形成。肝母细胞瘤患者的中位切缘为3毫米（范围1-15毫米）。13例患者中有12例实现了显微镜下切缘阴性。复发2例。中位随访时间38个月（范围12-144个月）后，所有13例肝母细胞瘤患者均存活且无疾病证据。2例复发患者存活且无疾病证据。结论：基于现有文献及本研究数据，我们认为（双）肝段切除术可成为经严格筛选的儿科患者的可行手术选择，且足以实现治愈。未来需通过更大规模数据集进一步评估实质保留性手术对手术及肿瘤学结局的影响。
肿瘤(癌症)患者之家