title: Clinical analysis of right anterior segmentectomy for hepatic malignancy.
abstract: OBJECTIVE
  Combined resection of segments 5 and 8, or right anterior segmentectomy, is one of the most difficult hepatic resections because of the danger of bleeding from the two major hepatic veins, the middle and right hepatic veins, during hepatectomy. We describe here the operative procedure and clinical analysis of right anterior segmentectomy in 35 patients with hepatic malignancy.
  
  
  METHODS
  Between March 1993 and December 2004, 35 patients underwent right anterior segmentectomy for hepatic malignancy. The technique used was based on the extraglissonian approach and parenchymal Kelly crushing, during which the two major hepatic veins were almost fully exposed.
  
  
  RESULTS
  Thirty-three patients had hepatocellular carcinoma, one had peripheral cholangiocellular carcinoma, and one had primary hepatic sarcoma. The mean operation time was 331 +/- 73 minutes and the mean transfusion of packed RBC was 1.09 +/- 1.57 pints. There was one in-hospital death as a result of sepsis and hepatic failure. The cumulative 1-, 2- and 5-year survival rates were 94%, 72% and 62%, respectively.
  
  
  CONCLUSIONS
  For surgeons who accurately know the anatomy of the liver, this procedure is safe and suitable in selected patients with hepatic malignancies and may increase the survival rate.
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. khkim620@amc.seoul.kr
authors.forename: Ki Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Hee Sung
authors.initials: HS
authors.lastname: Kim
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Kwang Min
authors.initials: KM
authors.lastname: Park
authors.forename: Shin
authors.initials: S
authors.lastname: Hwang
authors.forename: Chul Soo
authors.initials: CS
authors.lastname: Ahn
authors.forename: Deok Bog
authors.initials: DB
authors.lastname: Moon
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Ha
authors.forename: Yeon Dae
authors.initials: YD
authors.lastname: Kim
authors.forename: Kun Kook
authors.initials: KK
authors.lastname: Kim
authors.forename: Ki Won
authors.initials: KW
authors.lastname: Song
authors.forename: Sang Tae
authors.initials: ST
authors.lastname: Choi
authors.forename: Dong Sik
authors.initials: DS
authors.lastname: Kim
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Jung
authors.forename: Sung Gyu
authors.initials: SG
authors.lastname: Lee
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality; D016896:Treatment Outcome