Busweiler Linde A D, Wijnen Marc H W A, Wilde Jim C H, Sieders Egbert, Terwisscha van Scheltinga Sheila E J, van Heurn L W Ernest, Ziros Joseph, Bakx Roel, Heij Hugo A
Pediatric Surgical Center of Amsterdam, Emma Children's Hospital-Academic Medical Center and VU Medical Center, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
Department of Pediatric Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Pediatr Surg Int. 2017 Jan;33(1):23-31. doi: 10.1007/s00383-016-3989-8. Epub 2016 Oct 11.
Achievement of complete surgical resection plays a key role in the successful treatment of children with hepatoblastoma. The aim of this study is to assess the surgical outcomes after partial liver resections for hepatoblastoma, focusing on postoperative complications, resection margins, 30-day mortality, and long-term survival.
Chart reviews were carried out on all patients treated for hepatoblastoma in the Netherlands between 1990 and 2013.
A total of 103 patients were included, of whom 94 underwent surgery. Partial hepatectomy was performed in 76 patients and 18 patients received a liver transplant as a primary procedure. In 42 of 73 (58 %) patients, one or more complications were reported. In 3 patients, information regarding complications was not available. Hemorrhage necessitating blood transfusion occurred in 33 (45 %) patients and 9 (12 %) patients developed biliary complications, of whom 8 needed one or more additional surgical interventions. Overall, 5-year disease-specific survival was 82, 92 % in the group of patients who underwent partial hepatectomy, and 77 % in the group of patients who underwent liver transplantation.
Partial hepatectomy after chemotherapy in children with hepatoblastoma offers good chances of survival. This type of major surgery is associated with a high rate of surgical complications (58 %), which is not detrimental to survival.
实现完整的手术切除在肝母细胞瘤患儿的成功治疗中起着关键作用。本研究的目的是评估肝母细胞瘤部分肝切除术后的手术结果，重点关注术后并发症、切缘、30天死亡率和长期生存率。
对1990年至2013年间在荷兰接受肝母细胞瘤治疗的所有患者进行病历回顾。
共纳入103例患者，其中94例接受了手术。76例患者进行了部分肝切除术，18例患者接受了肝移植作为主要手术。在73例患者中的42例（58%）报告了一种或多种并发症。3例患者没有关于并发症的信息。33例（45%）患者发生了需要输血的出血，9例（12%）患者出现了胆道并发症，其中8例需要进行一次或多次额外的手术干预。总体而言，部分肝切除组患者的5年疾病特异性生存率为82%，肝移植组为92%，肝移植组为77%。
肝母细胞瘤患儿化疗后进行部分肝切除可提供良好的生存机会。这种大型手术与较高的手术并发症发生率（58%）相关，但这对生存并无不利影响。
