Objective To report the authors’ own experience and results of recent studies of anatomical liver resection for patients with hepatocellular carcinoma (HCC). Methods From January 2004 to June 2005, anatomical liver resection procedure were completed in 93 patients with HCC. Surgical techniques were designed to reduce intraoperative blood loss, blood transfusion and postoperative complications by parenchymal crushing with kelly forceps, inflow and outflow selective clamping. In 13 patients with large liver tumors, liver hanging maneuver performed in the course of hemihepatectomy. Liver transection with intermittent closure of the blood influx to the liver, using a Pringle manoeuvre. Results Of 93 patients undergoing hepatectomy for HCC, underlying cirrhosis was present in 82 (88%) patients. The median blood loss was 300 ml (100－6 000 ml) and 71%（66/93） of the patients did not require blood transfusion.The postoperative complication rate was 34%（32/93）, complications were primarily subphrenic collection (8 cases). Within 30 postoperative days, no death was recorded. Conclusion The anatomical liver resection of HCC may be improve the surgical outcome.
Objective Exploring the way to obtain long-term, high-quality survival of patients with primary liver cancer (PLC) by surgical resection. MethodReviewing the diagnosis, treatment and follow-up outcomes of 10 PLC patients who were most representative, confirmed by pathology and survived for 30 years or more after surgical treatment at Zhongshan Hospital, Affiliated to Fudan University from July 1958 to September 1995, and summarizing the successful experiences with references. ResultsCase one: male, 50-year-old. Case one survived for forty-three years of long-term survival after surgery, who was the ealiest one to break the 40-year survival barrier. Case 2: female, 36-year-old. Case 2 had remained tumor-free survival for 57 years after liver resection: the longest record of high-quality survival to date. Case 3: male, 31-year-old. Case 3 had remained 51-year tumor-free survival after resection of a giant (17 cm) hepatocellular carcinoma. Case 4: male, 19-year-old. The patient, suspected of liver cancer based only on abnormally elevated alpha-fetoprotein (AFP) in the 1970s, underwent surgical exploration with immediate liver cancer resection, and had since enjoyed 50 years of tumor-free survival. Case 5: male, 59-year-old. The patient survived to be 103 years old after undergoing liver cancer resection and subsequent pulmonary metastasis resection with tumor-free survival of 43 years. Case 6: female, 19-year-old. The patient survived 50 years after undergoing liver cancer resection. Her liver cancer was found on abnormally elevated AFP in liver cancer screening in the 1970s. She gave birth to a healthy baby girl 10 years after the operation. Now the mother and daughter lead a happy life. Case 7: male, 44-year-old. The patient with a massive liver cancer undervent three sequential surgical interventions: hepatic artery ligation and cannulation, hepatectomy for the primary tumor, and re-resection of recurrent tumor. He had survived for 45 years postoperatively and well. Case 8: male, 57-year-old. The patient with liver cancer accompanied by thrombus in the left hepatic vein and survived for 38 years after undergoing an En Bloc liver cancer resection including removal of the cancer thrombus. Case 9: male, 48-year-old. The patient with hilar liver cancer (segment Ⅷ) had been living healthily for 32 years after a thrilling liver resection. Case 10: 18-month-old, baby girl. The female infant survived 32 years after undergoing liver cancer resection. Now she had grown up, gotten married, had her own children, and the family is living a happy life. ConclusionSurgical resection is the most thorough treatment method, enabling liver cancer patients to achieve long-term or even miraculous survival outcomes.
