• J. Am. Coll. Surg. · Aug 2022

    Long-Term Outcomes of Mesohepatectomy for Centrally Located Liver Tumors: Two-Decade Single-Center Experience.

    • Arianeb Mehrabi, Ali Ramouz, Mohammad Golriz, Elias Khajeh, Thilo Hackert, Beat Müller-Stich, Oliver Strobel, Katrin Hoffmann, Markus W Büchler, and Liver Cancer Center Heidelberg (LCCH).
    • From the Department of General, Visceral, and Transplantation Surgery (Mehrabi, Ramouz, Golriz, Khajeh, Hackert, Müller-Stich, Strobel, Hoffmann, Büchler), Heidelberg University Hospital, 69120 Heidelberg, Germany.
    • J. Am. Coll. Surg. 2022 Aug 1; 235 (2): 257266257-266.

    BackgroundMesohepatectomy is a viable treatment option for patients diagnosed with centrally located liver tumors (CLLTs). There are several reports from Eastern centers, but few data are available on this topic from Western centers.Study DesignData of 128 consecutive patients who underwent mesohepatectomy between September 2000 and September 2020 in our center were analyzed from a prospectively collected database. Patient demographic data, liver tumor characteristics, and intraoperative data were collected. In addition, posthepatectomy bile leakage (PHBL), posthepatectomy hemorrhage (PHH), posthepatectomy liver failure (PHLF), and 90-day mortality after mesohepatectomy were assessed. Long-term outcomes were also reported, and factors that may influence disease-free survival were evaluated.ResultsOf 128 patients, 113 patients (88.3%) had malignant hepatic tumors (primary and metastatic tumors in 41 [32%] and 72 [56.3%] patients, respectively), and 15 patients suffered from benign lesions (11.7%). Among the relevant surgical complications (grade B or C), PHBL was the most common complication after mesohepatectomy and occurred in 11.7% of patients, followed by PHLF in 3.1% of patients and PHH in 2.3% of patients. Only four patients (3.1%) died within 90 days after mesohepatectomy. The 5-year overall survival and overall recurrence (for malignant lesion) rates were 76.5% and 45.1%, respectively.ConclusionMesohepatectomy is a safe and feasible surgical treatment with low morbidity and mortality for patients with CLLT. Long-term outcomes can be improved by increased surgical expertise.Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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