title: Surgical management of intrahepatic vessels in children with stage III/IV hepatoblastoma.
abstract: BACKGROUND
  Hepatoblastoma (HB) is a rare childhood tumor. We investigated the effect of intraoperative management of the intrahepatic major vessels in children with HB.
  
  
  METHODS
  Between April 2005 and August 2012, surgical resection was performed on 50 children with hepatoblastoma. These children were divided into a vessel-ligation group (n = 20) and a vessel-repair group (n = 30). In the vessel-ligation group, the intrahepatic major vessels were ligated and removed together with the tumor and the affected liver lobe/liver parenchyma. In the vessel-repair group, the affected intrahepatic major vessels were dissected and preserved as much as possible and the normal liver lobe/liver parenchyma and blood supply from these vessels were also preserved. The outcomes were analyzed by postoperative follow-up.
  
  
  RESULTS
  In the vessel-ligation group, two patients gave up surgery, six patients underwent palliative resection, and 12 patients underwent en bloc resection; four patients died of liver failure and eight patients fully recovered and were discharged. In the vessel-repair group, all 30 patients underwent en bloc resection and were discharged after satisfactory healing. After a follow-up time of 5 - 36 months (median: 20 months), two patient in the vessel-ligation group survived and 22 patients in the vessel-repair group survived.
  
  
  CONCLUSIONS
  Patients with HB can be successfully treated by tumor resection with vascular repair. This method prevents postoperative liver failure, ensures patient safety during the perioperative period, and allows for early chemotherapy.
authors.affiliation: Department of Surgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Yan-li
authors.initials: YL
authors.lastname: Pang
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.forename: He-ying
authors.initials: HY
authors.lastname: Yang
authors.forename: Qiu-liang
authors.initials: QL
authors.lastname: Liu
authors.forename: Da
authors.initials: D
authors.lastname: Zhang
authors.forename: Pan
authors.initials: P
authors.lastname: Qin
authors.forename: Ming
authors.initials: M
authors.lastname: Yue
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Jun-jie
authors.initials: JJ
authors.lastname: Zhang
authors.forename: Jia-xiang
authors.initials: JX
authors.lastname: Wang
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018197:Hepatoblastoma / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging