Part of the book: Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third leading cause of cancer-related deaths. Up to now, surgery remains to be the main curative strategy for hepatocellular carcinoma. In this article the author summarizes his experiences of 30 years in right trisectionectomy for huge liver tumor. A total of 459 primary liver cancer patients were hepatomized in author's group. Among them, 33 cases of right trisectionectomies were performed under continuous single interruption of the porta hepatis. The 1-, 3-, and 5-year survival rates were 71.9%, 40.6%, and 34.4%, respectively. The longest cancer-free survival of right trisectionectomy in our group is 26 years. In the author's another cohort, 51 patients underwent hepatectomy without allogeneic blood transfusion. Compared with the control group containing 60 patients who underwent hepatectomy with allogeneic blood transfusion, the morbidity and recurrence rates in the group without allogeneic blood transfusion were significantly decreased (P < 0.05). Surgical anatomy study of the hepatic veins and case reports are also included in this article. Taken together, it is obvious that right trisectionectomy under continuous single interruption of the porta hepatis without allogeneic blood transfusion would benefit the patient with resectable huge HCC.
Part of the book: Recent Advances in Liver Diseases and Surgery