Total vascular exclusion technique for resection of hepatocellular carcinoma.
OBJECTIVE
To improve the low resection rate, poor prognosis and to control the massive hemorrhage during operation, total vascular exclusion (TVE) technique was used in hepatectomies of advanced and complicated hepatocellular carcinomas (HCCs).


METHODS
Five hundred and thirty patients with HCCs were admitted in our hospital. They were divided into TVE technique group (group A: n=78), Pringle maneuver method group (group B: n=176) and unresectable group (group C: n=276). The clinical, operative, pathological parameters and outcome of the patients were statistically evaluated.


RESULTS
Group A had a significantly higher resection rate than group B (accounting for 47.92% and 33.21% respectively). There was no significant difference in blood loss, blood transfusion and perioperative mortality between groups A and B. Both groups had the similar median disease free survival time (14.6 vs 16.3 months) and 1 year survival rate (92.9% vs 95.5%). The TVE group had a medial survival time of 40.5 months and its 5-year survival rate was 34.6%.


CONCLUSIONS
As compared with Pringle maneuver method, the total vascular exclusion is a safe and effective technique to increase the total resection rate of advanced and complicated HCCs.
Yin
Zhen-Yu
ZY
Institute of General Surgery, School of Medicine, Nanjing University, Jiangsu Province, China. davidmd@sohu.com
Wang
Xiao-Ming
XM
Yu
Ren-Xiang
RX
Zhang
Bai-Meng
BM
Yu
Ke-Ke
KK
Li
Ning
N
Li
Jie-Shou
JS
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000601:surgery; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate