title: Precise local resection for hepatocellular carcinoma based on tumor-surrounding vascular anatomy revealed by 3D analysis.
abstract: OBJECTIVE
  Local resection for hepatocellular carcinoma (HCC) has been traditionally performed non-anatomically. The purpose of this study is to evaluate the feasibility of precise local resection of HCC according to the anatomy of tumor-surrounding vessels revealed by three-dimensional (3D) analysis technique.
  
  
  METHODS
  The CT datasets of the livers of the patients with HCC were analyzed three-dimensionally. The tumor-bearing vessels were identified and virtually resected, and the depending parenchymal volume was calculated for definition of an optimal liver division plane. The actual local resections were then carried out according to the simulations.
  
  
  RESULTS
  Precise local resection based on tumor-surrounding vascular anatomy was performed in 13 HCC patients. Both resection margin and volume were significantly correlated with those predicted by preoperative simulations. After precise local resection, neither ischemia nor congestion was observed in the remnant livers. All patients obtained adequate resection margins, without recurrences in the resection sites after a median follow-up time of 18 months.
  
  
  CONCLUSIONS
  Local resection for HCC can be carried out precisely according to the anatomy of tumor-surrounding vessels when guided by a 3D analysis. This precise procedure will enhance both the accuracy and safety of traditional local resection.
authors.affiliation: Eastern Hepatobiliary Surgery Hospital, Shanghai, PR China. wangyi-ehbh@163.com
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Youlei
authors.initials: Y
authors.lastname: Zhang
authors.forename: Heinz-Otto
authors.initials: HO
authors.lastname: Peitgen
authors.forename: Andrea
authors.initials: A
authors.lastname: Schenk
authors.forename: Lei
authors.initials: L
authors.lastname: Yuan
authors.forename: Gongtian
authors.initials: G
authors.lastname: Wei
authors.forename: Yanfu
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007430:Intraoperative Care / Q000379:methods; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface