Hepatic trisegmentectomy for 29 patients with huge liver neoplasms.

OBJECTIVE: To evaluate retrospectively the feasibility and effect of hepatic trisegmentectomy in therapy of huge neoplasms of the liver.
METHODS: From July 1993 to October 1999, 29 patients with huge hepatic neoplasms underwent hepatic trisegmentectomy. Of these, 23 patients suffered from primary liver cancer, 1 hepatic infiltration of gallbladder cancer, 1 metastasis of colon cancer, 1 hepatic angiosarcoma, 1 hepatic neurofibroma, and 2 huge liver cysts. Twenty-six patients were subjected to right trisegmentectomy and the rest 3 left trisegmentectomy. All trisegmentectomies were performed under normothermic interruption of the porta hepatis at single time and these interruptions lasted 15 to 40 minutes.
RESULTS: The relatively good effect was seen in our series. The 1-, 3-, 5-year survival rates for primary liver cancer patients were 63.6%, 36.4% and 27.3%, respectively. The survival period for the patients with hepatic infiltration of gallbladder cancer and liver metastasis of colon cancer was 6 months. Those with hepatic angiosarcoma, hepatic neurofibroma and huge liver cysts have been surviving 35, 26, 25 and 40 months, respectively. Major complications were noted in 5 patients, and one (3.4%, 1/29) died.
CONCLUSION: Hepatic trisegmentectomy is safe and effective in treatment of huge hepatic neoplasms if its indications and operative techniques are properly mastered.