[Surgical management of small intrahepatic lesions adjacent to the major vasculature].
OBJECTIVE
To assess the feasibility and the significance of surgical resection of small intrahepatic lesions adjacent to the major vasculature.


METHODS
The results of treatment were retrospectively reviewed in 40 patients who received operation for intrahepatic lesions less than 3 cm in diameter between Jan. 2003 and Dec. 2005. The lesions were all adjacent to the major vasculature in the liver.


RESULTS
In the 40 patients, a total of 44 small intrahepatic lesions were successfully resected with minimal morbidity and blood loss (mean 163 ml). A second lesion was found in 4 patients (10%) during intraoperative exploration. Histologically the lesion was malignant in 29 cases (including 4 cases with two lesions) and benign in 11 cases, with correct preoperative diagnosis in 62.5% of all cases. For 26 patients with hepatocellular carcinoma, the 1-, 2-, and 3-year postoperative survival rates were 90.1%, 83.2% and 64.7%, respectively, while the patients with benign lesions were cured with the operation.


CONCLUSIONS
Surgical resection of small intrahepatic lesions adjacent to the major vasculature is demanding but feasible and with satisfying effect. The significance of surgical management of these small lesions is not only excising the lesions but also making definite diagnosis and finding new lesions in some patients.
Wang
Yi
Y
Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai 200438, China. wangyiehbh@yahoo.com
Sun
Yan-fu
YF
Chen
Ke-ji
KJ
Wei
Gong-tian
GT
Hu
Lei
L
Wu
Meng-chao
MC
D000328:Adult; D000368:Aged; D001808:Blood Vessels / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies