Resection of huge liver tumor without vascular exclusion in children

Objective To investigate the results of resection of huge liver tumor without using vascular exclusion maneuver.Methods Sixteen children with huge liver tumor underwent hepatectomy without hepatic vascular exclusion in our hospital.Their age ranged from 28d to 14years.The diameter of the tumor was from 11 to 23cm.In these patients,9 were hepatoblastoma,4 with hamartoma and the other 3 with hemangioendothelioma.Results Resection of the liver tumor without the vascular exclusion was successfully accomplished in all patients.Right hemihepatectomy(segments V to VIII) was undertaken in 8 cases,right trihepatectomy(segments I,IV,V to VIII) in 4,and left trihepatectomy(segments I to V and VIII),left hemihepatectomy,segment IV,VII and VIII and segment V and VI resections in each one respectively.During the follow-up(6 to 45 months),15 patients survived without tumor recurrence.The other one patient with two tumors in right and left lobes died of brain and lung metastasis at 7 months after operation.Conclusions Resection of tumor without vascular exclusion is an effective,safe and feasible operation for children with huge liver tumor.