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Сравнение результатов резекции центральных сегментов печени и расширенной гемигепатэктомии по поводу новообразований печени у детей

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Цель. Анализ безопасности и преимуществ центральной резекции по сравнению с расширенной резекцией печени. Материал и методы. С июня 2017 по май 2020 г. хирургическое лечение в объеме центральной и расширенной резекции по поводу новообразований печени перенесли 29 детей. Центральная резекция выполнена 8 детям, расширенная гемигепатэктомия - 21. Проведен анализ результатов предоперационного обследования, интраоперационного и послеоперационного периода в обеих группах. Результаты. У большинства обследованных детей диагностировали гепатобластому. Объем будущего остатка печени (FLR) в группе центральной резекции был больше (р = 0,003). Достоверных различий в продолжительности операции (р = 0,94), интраоперационной кровопотере (р = 0,078), объеме гемотрансфузии (р = 0,057), частоте послеоперационных осложнений, продолжительности послеоперационного периода (р = 0,3) не выявлено. Заключение. При схожей частоте и характере послеоперационных осложнений резекции центральных сегментов печени у детей безопасны и позволяют сохранить больший объем здоровой паренхимы органа.

Ключевые слова:
печень, центральная резекция, мезогепатэктомия, расширенная гемигепатэктомия, опухоль печени, дети, результаты, liver, central liver resections, mesohepatectomy, extended hepatectomies, pediatric liver tumors, children, outcomes

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The comparison of central hepatic segments resection versus extended hepatectomies outcomes in children with liver tumors

Aim. To analyze the safety and advantages of central resection in comparison with extended hepatectomies. Methods. From June 2017 to May 2020 29 central and extended liver resections for children were performed. Central hepatic resections were carried out in 8, extended hepatectomies - in 21 patients. Preoperative investigations, intraoperative and postoperative data in both groups were analyzed. Results. The main indication for surgery was hepatoblastoma. Future liver remnant volume was significantly higher in central resections group (р = 0.003). No difference in median operative time (р = 0.94), intraoperative blood loss (р = 0.078) and blood transfusion rate (р = 0.057) were found between groups. There were no postoperative complications difference. Also no difference in hospital stay length (р = 0.3) were found. Conclusion. In comparison with extended procedures, central liver resection has similar complication rate. Central hepatectomy is a safe procedure in children with liver tumors, which allows to preserve more healthy parenchyma.

Keywords:
печень, центральная резекция, мезогепатэктомия, расширенная гемигепатэктомия, опухоль печени, дети, результаты, liver, central liver resections, mesohepatectomy, extended hepatectomies, pediatric liver tumors, children, outcomes