title: [Surgical treatment for the giant hepatic carcinomas occupying the central part of the liver].
abstract: OBJECTIVE
  To evaluate the techniques and the effects of surgical resection of giant hepatic carcinomas which occupied the central part of the liver.
  
  
  METHODS
  A retrospective study was carried out of hepatectomies performed for central giant hepatic carcinomas. The hepatic tumors included in this study were hepatocellular carcinomas, cholangiocarcinomas and hepatic metastases which situated in the central part of the liver (segment IV, V, VIII, I) with a diameter of larger than 10 cm and involved hepatocaval confluence, retrohepatic inferior vena cava (IVC) as well as hepatic portal.
  
  
  RESULTS
  A total of 40 central giant hepatic carcinomas were successfully resected, with a mean diameter of 13.6 cm (range 10.5-19.0 cm). The types of the hepatectomies conducted were as follows: extended mid-hepatectomy in 9 cases, atypical mid-hepatectomy in 13 cases, extended left hepatectomy in 13 cases, total caudatectomy plus extended left hepatectomy in 3 cases and extended right hepatectomy in 2 cases. The mean operation time was 197 min (range 90 - 380 min) and the mean intraoperative blood lose 1,596 ml (range 300-11,000 ml), with operative mortality and morbidity being 0 and 20%, respectively. The postoperative 1, 3 and 5 year survival rates for the patients were 88%, 56% and 28%, respectively.
  
  
  CONCLUSIONS
  The hepatic carcinomas of central type, when larger than 10 cm in diameter, frequently involves all the hepatic portal, hepatocaval confluence and retrohepatic IVC. Surgical resection of this kind of tumor, though sophisticated in technique, is safe and effective and, therefore, the first choice of the treatments.
authors.affiliation: Second Department of Hepatic Surgery, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Han
authors.initials: H
authors.lastname: Chen
authors.forename: Meng-chao
authors.initials: MC
authors.lastname: Wu
authors.forename: Yan-fu
authors.initials: YF
authors.lastname: Sun
authors.forename: Gong-tian
authors.initials: GT
authors.lastname: Wei
authors.forename: Chuan
authors.initials: C
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome