Objective To evaluate the approaches and surgical technique for resection of the lesions occupying different parts of the caudate lobe of the liver. Methods The clinical data of cases undergoing resection of lesions originating in the caudate lobe were retrospectively analysed. The operative procedures were chosen according to lesion location. Results A total of 32 patients were operated on. The surgical technique included left, right and anterior transhepatic approach. The mean operative time was (198?73)min (range 60～345 min) and the mean intraoperative blood loss (917?914)ml (range 100～4?500 ml). There was no operative death, with complications occurring in 4 patients (12%). The patients with benign hepatic tumor are all alive after operation and the 1, 2, 3 and 4 year survival rates for the patients with malignant hepatic tumor were 87%, 59%, 43% and 43%, respectively. Conclusion Resection of the caudate lobe lesions different both in sizes and locations varies greatly in operative complexity, with combined hepatectomy being most difficult. Bilateral surgical approaches are suitable for almost all caudate lobectomies.

Objective To investigate the clinicopathological features of undifferentiated embryo-nal sarcoma of the liver (UESL). Methods The clinical data of 9 UESL cases treated in our hospital between 1996 and 2007 were retrospectively analyzed. Results The patients were children and young adults. Clinical presentation was typically an abdominal mass that may be accompanied by pain and fe-ver. Tumors were all removed surgically in the 9 patients. Conclusion UESL is an unusual malignan-cy of the liver. Discrepancy of internal architecture between US and CT is one of the important charac-teristic of UESL. Whenever feasible, surgical resection should be attempted as a part of combination modalities. Modern rnultimodal treatment and supportive therapy might promote the survival rate.

ObjectiveThis study was to review our experience for the management of hepatocellular carcinoma(HCC) invading the inferior vena cava(IVC). Methods Eleven patients were operated on. Tumors were first resected under portal triad clamping(PTC) and then the tumor emboli in the IVC were removed either under hepatic vascular exclusion(HVE) or under side clamping of the IVC. Results Surgery was successful in all cases, without operative death and complication caused by the removals of tumor emboli from the IVC. The mean operative time was 179 min (range 120～255 min) and the mean intraoperative blood loss 1 482 ml(range 600～3 000 ml). The mean PTC and HVE times were 27 9 min(range 12～83 min) and 16 5 min(range 7～28 min), respectively. The postoperative complications included pleural effusion in one needing thorancentesis and bile leak in one. During the follow up, 3 patients died at 30, 10 and 14 months, respectively, and the remaining 8 patients were alive at the follow up of 1 to 14 months. ConclusionsHCC with tumor thrombus in the IVC is operable and the proper procedure is hepatectomy plus thrombectomy with a favourable postoperative prognosis.

OBJECTIVETo observe the curative effect of percutaneous microwave coagulation therapy (PMCT) with 2450 MHz microwave antenna for hepatocellular carcinoma.

METHODSUnder local or epidural anesthesia, a thin percutaneous microwave antenna was introduced with ultrasound guidance into the tumor in the liver for thermo-coagulation.

RESULTSAmong the 97 hepatic cancer lesions in 52 patients, 61(62.9%) with phi < 3 cm were coagulated once. In follow-up of 6-12 months of these lesions, 57(93.4%) showed no recurrence by CT or MRI. Thirty-six (37.1%) with 3 cm < phi < 5 cm coagulated twice showed that 27 (75.0%) gave CR and 9 (25.0%) gave PR by CT or MRI in follow up of 6 months. There were no serious clinical side effects or complications in the PMCT patients.

CONCLUSIONPercutaneous microwave coagulation therapy gives good curative effect on liver tumor with phi < 3 cm. It is partly effective on lesions 3 cm < phi < 5 cm.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; therapy ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Treatment Outcome

OBJECTIVESTo evaluate the surgical techniques and feasibility for resecting the hepatic caudate lobe including the paracaval portion.

METHODSRight posterior approach for right caudate lobectomy and left lateral approach for total caudate lobectomy were taken with or without some kinds of preparatory segmentectomies.

RESULTSSeven right and 6 total caudate lobectomies, all including paracaval portion, ware accomplished without operative death. The mean intraoperative blood loss was 896.15 (250 - 2 000) ml and the mean portal triad clamping time was 25.4 (10 - 83) min. The postoperative course was uneventful for all the cases, and the mean hospital stay was 12 (9 - 22) days.

CONCLUSIONSAlthough being complicated anatomically, resection of the hepatic caudate lobe including the paracaval portion is feasible with a high safety.

Aged ; Feasibility Studies ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Vena Cava, Inferior