Primary outcomes after major anatomical liver resections in infants at the National Children’s Medical Center

Semash K.O.; Dzhanbekov T.A.

doi:https://doi.org/10.17116/hirurgia202504186

Semash K.O.

National Children’s Medical Center

ORCID: 0000-0001-5830-5235

Dzhanbekov T.A.

National Children’s Medical Center

ORCID: 0000-0002-8857-947X

Primary outcomes after major anatomical liver resections in infants at the National Children’s Medical Center

Authors:

Semash K.O., Dzhanbekov T.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(4): 86‑94

DOI: 10.17116/hirurgia202504186

Read: 894 times

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To cite this article:

Semash KO, Dzhanbekov TA. Primary outcomes after major anatomical liver resections in infants at the National Children’s Medical Center. Pirogov Russian Journal of Surgery. 2025;(4):86‑94. (In Russ.)
https://doi.org/10.17116/hirurgia202504186

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

OBJECTIVE

To analyze the results of major right-sided hemihepatectomies in infants with various neoplasms.

MATERIAL AND METHODS

There were 3 right-sided major hemihepatectomies in pediatric patients aged 5—10 months for different neoplasms between December 2023 and May 2024. Perioperative data of patients, indications for liver resection, and postoperative outcomes were retrospectively analyzed.

RESULTS. M

Ean age of patients was 7.3 months. The indications for liver resection were hepatoblastoma in two cases and anastomosing hemangioma in one case. Two patients underwent anatomical resection of the right hepatic lobe, and one patient underwent extended right-sided hemihepatectomy. Mean surgery time was 230 min, blood loss — 133 ml. No surgical complications were observed. Mean hospital-stay after surgery was 7.3 days. Patients with hepatoblastoma received postoperative chemotherapy. No recurrence of neoplasms was detected throughout the follow-up period.

CONCLUSION

Primary results of liver resections demonstrated feasibility and safety of radical major hemihepatectomies in pediatric patients with large liver neoplasms. These outcomes are comparable with world literature. Such interventions in infants necessitate substantial experience in hepatobiliary surgery. Patients with hepatoblastoma require post-hepatectomy chemotherapy. There is a need to develop primary outpatient services for liver tumor screening and timely diagnosis in pediatric patients.

Keywords:

liver resection

major hemihepatectomy

pediatric surgery

oncology

Authors:

Semash K.O.

National Children’s Medical Center

ORCID: 0000-0001-5830-5235

Dzhanbekov T.A.

National Children’s Medical Center

ORCID: 0000-0002-8857-947X

Received:

21.06.2024

Accepted:

04.07.2024

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References:

Li K, Jiang F, Aizpuru M, Larson EL, Xie X, Zhou R, Xiang B. Successful management and technical aspects of major liver resection in children: A retrospective cohort study. Medicine. 2021;100(6):e24420. https://doi.org/10.1097/MD.0000000000024420
Iwatsuki S, Starzl TE. Hepatectomy in children. International Advances in Surgical Oncology. 1982;5:163-171.
Abdelkader HM, Abdel-Latif M, Abdelsattar M, Youssef AA. Hepatic resection in children: highlighted and revisited steps. Egypt Pediatric Association Gaz. 2019;67(3). https://doi.org/10.1186/s43054-019-0008-4
Semash KO, Gautier SV. Review of surgical techniques for performing laparoscopic donor hepatectomy. Russian Journal of Transplantology and Artificial Organs. 2020;22(4):149-153. (In Russ.). https://doi.org/10.15825/1995-1191-2020-4-149-153
Semash K, Dzhanbekov T, Akbarov M, Mirolimov M, Usmonov A, Rozzakov N et al. Implementation of Living Donor Liver Transplantation Program in the Republic of Uzbekistan — Report of First 40 cases. Clinical Transplantation and Research. 2024;38(2):116-127. https://doi.org/10.4285/ctr.24.0013
Semash K, Dzhanbekov T, Abduazizov M, Alimov A. The first case report of major right-sided hepatectomy in infant patient in National Children’s Medical Center. CAJM. 2023;(4):5-10.
Towbin AJ, Meyers RL, Woodley H, Miyazaki O, Weldon CB, Morland B, Hiyama E, Czauderna P, Roebuck DJ, Tiao GM. PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatric Radiology. 2018;48(4):536-554. https://doi.org/10.1007/s00247-018-4078-z
Thompson H, Jones C, Pardy C, Kufeji D, Nichols E, Murphy F, Davenport M. Application of the Clavien-Dindo classification to a pediatric surgical network. Journal of Pediatric Surgery. 2020;55(2):312-315. https://doi.org/10.1016/j.jpedsurg.2019.10.032
Slankamenac K, Graf R, Barkun J, Puhan MA, Clavien PA. The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Annals of Surgery. 2013;258(1):1-7. https://doi.org/10.1097/SLA.0b013e318296c732
Semash K, Dzhanbekov T, Abduazizov A, Tashmatov S. Anastomosing hemangioma of the liver in infant: a case report. Journal of Pediatric Surgery Case Reports. 2024;107:102838. https://doi.org/10.1016/j.epsc.2024.102838
Lin CC, Chen CL, Cheng YF, Chiu KW, Jawan B, Hsaio CC. Major hepatectomy in children: approaching blood transfusion-free. World Journal of Surgery. 2006;30(6):1115-1119. https://doi.org/10.1007/s00268-005-0607-7
Akhaladze DG, Rabaev GS, Merkulov NN, Tverdov IV, Grachev NS. Extensive liver resection in a child with an extremely low future liver remnant volume. Pediatric Hematology/Oncology and Immunopathology. 2021;20(4):139-144. (In Russ.). https://doi.org/10.24287/1726-1708-2021-20-4-139-144
Stringer MD, Hennayake S, Howard ER, Spitz L, Shafford EA, Mieli-Vergani G, Saxena R, Malone M, Dicks-Mireaux C, Karani J, et al. Improved outcome for children with hepatoblastoma. British Journal of Surgery. 1995;82(3):386-391. https://doi.org/10.1002/bjs.1800820334
Wang WD, Liang LJ, Huang XQ, Yin XY. Low central venous pressure reduces blood loss in hepatectomy. World Journal of Gastroenterology. 2006;12(6):935-939
Schnater JM, Aronson DC, Plaschkes J, Perilongo G, Brown J, Otte JB, Brugieres L, Czauderna P, MacKinlay G, Vos A. Surgical view of the treatment of patients with hepatoblastoma: results from the first prospective trial of the International Society of Pediatric Oncology Liver Tumor Study Group. Cancer. 2002;94(4):1111-1120. https://doi.org/10.1002/cncr.10282
Busweiler LA, Wijnen MH, Wilde JC, Sieders E, Terwisscha van Scheltinga SE, van Heurn LW, Ziros J, Bakx R, Heij HA. Surgical treatment of childhood hepatoblastoma in the Netherlands (1990-2013). Pediatric Surgery International. 2017;33(1):23-31. https://doi.org/10.1007/s00383-016-3989-8
Zdujic P, Bogdanovic A, Djindjic U, Kovac JD, Basaric D, Zdujic N, Dugalic V. Impact of prolonged liver ischemia during intermittent Pringle maneuver on postoperative outcome following liver resection. Asian Journal of Surgery. 2024;S1015-9584(24)00432-9. https://doi.org/10.1016/j.asjsur.2024.03.005
Hanaki T, Tsuda A, Sunaguchi T, Goto K, Morimoto M, Murakami Y, Kihara K, Matsunaga T, Yamamoto M, Tokuyasu N, Sakamoto T, Hasegawa T, Fujiwara Y. Influence of the water jet system vs cavitron ultrasonic surgical aspirator for liver resection on the remnant liver. World Journal of Clinical Cases. 2022;10(20):6855-6864. https://doi.org/10.12998/wjcc.v10.i20.6855
Razumovsky AY, Smirnov AN, Kholostova VV, Alkhasov AB, Mitupov ZB, Sergeeva SV. Experience in the implementation of extensive liver resections in children. Russian Journal of Pediatric Surgery. 2018;22(6):284-287. (In Russ.). https://doi.org/10.18821/1560-9510-2018-22-6-284-287
Zwintscher NP, Azarow KS, Horton JD. Morbidity and mortality associated with liver resections for primary malignancies in children. Pediatric Surgery International. 2014;30(5):493-7. https://doi.org/10.1007/s00383-014-3492-z