hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.202018-17hepato-597Research ArticleПЕЧЕНЬLIVERРезекции центральных сегментов печени у детейCentral segments liver resection for pediatric tumorshttps://orcid.org/0000-0002-1387-209XАхаладзеД. Г.AkhaladzeD. G.

Ахаладзе Дмитрий Гурамович – канд. мед. наук, руководитель группы торакоабдоминальной хирургии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Тел.: 8-905-587-89-92

Cand. of Sci. (Med.), Head of Thoracoabdominal Surgery Group

1, Samory Mashela str., Moscow, 117997, Russian Federation

Phone: +7-905-587-89-92

d.g.akhaladze@gmail.comhttps://orcid.org/0000-0002-3704-8783КачановД. Ю.KachanovD. Y.

доктор мед. наук, заведующий отделением клинической онкологии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Doct. of Sci. (Med.), Head of the Department of Clinical Oncology

1, Samory Mashela str., Moscow, 117997, Russian Federation

kachanov78@gmail.comhttps://orcid.org/0000-0001-9424-1646УсковаН. Г.UskovaN. G.

канд. мед. наук, врач детский хирург отделения онкологии и детской хирургии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Cand. of Sci. (Med.), Pediatric Surgeon of the Department of Pediatric Oncology and Surgery

1, Samory Mashela str., Moscow, 117997, Russian Federation

nataliyauskova@gmail.comhttps://orcid.org/0000-0002-3280-8667МелехинаО. В.MelekhinaO. V.

канд. мед. наук, врач-хирург отделения рентгенхирургических методов диагностики и лечения

111123, Москва, шоссе Энтузиастов, д. 86, Российская Федерация

Cand. of Sci. (Med.), Surgeon, Department of Inteventional Radiology

86, Shosse Entuziastov, 111123, Russian Federation

o.melekhina@mknc.ruhttps://orcid.org/0000-0003-0404-6420МеркуловН. Н.MerkulovN. N.

врач детский хирург отделения онкологии и детской хирургии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Pediatric Surgeon of the Department of Pediatric Oncology and Surgery

1, Samory Mashela str., Moscow, 117997, Russian Federation

dr.mernich@yandex.ruhttps://orcid.org/0000-0002-5308-6544ТалыповС. Р.TalypovS. R.

канд. мед. наук, врач детский хирург отделения онкологии и детской хирургии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Cand. of Sci. (Med.), Pediatric Surgeon of the Department of Pediatric Oncology and Surgery

1, Samory Mashela str., Moscow, 117997, Russian Federation

riumych@yandex.ruhttps://orcid.org/0000-0002-7945-2565ЩукинВ. В.SchukinV. V.

канд. мед. наук, заведующий отделением анестезиологии и реанимации с операционным блоком

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Cand. of Sci. (Med.), Head of the Department of Anaesthesiology and Intensive Therapy with an Operating Unit

1, Samory Mashela str., Moscow, 117997, Russian Federation

schukinv@gmail.comhttps://orcid.org/0000-0002-6922-1077ЖилкинИ. В.ZhilkinI. V.

канд. мед. наук, врач-педиатр отделения онкологии и детской хирургии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Cand. of Sci. (Med.), Pediatritian of the Department of Pediatric Oncology and Surgery

1, Samory Mashela str., Moscow, 117997, Russian Federation

izhilkin@gmail.comhttps://orcid.org/0000-0002-5691-2522РабаевГ. С.RabaevG. S.

врач-ординатор отделения онкологии и детской хирургии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Resident of the Department of Pediatric Oncology and Surgery

1, Samory Mashela str., Moscow, 117997, Russian Federation

rabaevgesha@gmail.comhttps://orcid.org/0000-0002-9654-084XМоисеенкоР. А.MoiseenkoR. A.

врач детский онколог отделения клинической онкологии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Pediatric Oncologist of the Department of Clinical Oncology

1, Samory Mashela str., Moscow, 117997, Russian Federation

doctor-moiseenko@yandex.ruhttps://orcid.org/0000-0002-4451-3233ГрачевН. С.GrachevN. S.

доктор мед. наук, заведующий отделением онкологии и детской хирургии

117997, Москва, ул. Саморы Машела, д. 1, Российская Федерация

Doct. of Sci. (Med.), Head of the Department of Pediatric Oncology and Surgery

1, Samory Mashela str., Moscow, 117997, Russian Federation

nick-grachev@yandex.ruФГБУ “Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева” Министерства здравоохранения Российской ФедерацииРоссияDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology Ministry of Health of Russian FederationRussian FederationГБУЗ “Московский клинический научный центр им. А.С. Логинова” Департамента здравоохранения МосквыРоссияLoginov Moscow Clinical Scientific Center, Department of Health of MoscowRussian Federation202017032020251817Copyright © Ахаладзе Д.Г., Качанов Д.Ю., Ускова Н.Г., Мелехина О.В., Меркулов Н.Н., Талыпов С.Р., Щукин В.В., Жилкин И.В., Рабаев Г.С., Моисеенко Р.А., Грачев Н.С., 20202020Ахаладзе Д.Г., Качанов Д.Ю., Ускова Н.Г., Мелехина О.В., Меркулов Н.Н., Талыпов С.Р., Щукин В.В., Жилкин И.В., Рабаев Г.С., Моисеенко Р.А., Грачев Н.С.Akhaladze D.G., Kachanov D.Y., Uskova N.G., Melekhina O.V., Merkulov N.N., Talypov S.R., Schukin V.V., Zhilkin I.V., Rabaev G.S., Moiseenko R.A., Grachev N.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/597Цель

Цель. Анализ ближайших результатов резекций центральных сегментов печени у детей на основании начального опыта.

Материал и методы

Материал и методы. Анализировали данные пациентов с различными центрально расположенными новообразованиями печени. В настоящее ретроспективное исследование включены 3 пациента с гепатобластомой, 1 наблюдение мезенхимальной гамартомы печени и 1 пациент с гепатоцеллюлярным раком. За период с марта по октябрь 2018 г. этим пациентам выполнены различные виды центральной резекции печени. Представлены технические аспекты, а также ближайшие результаты лечения.

Результаты

Результаты. Медиана возраста пациентов составила 78 мес (9 мес – 12 лет). Выполнили сегментэктомию 4b, бисегментэктомию 4b, 5, трисегментэктомию 4–6, мезогепатэктомию (анатомическую сегментэктомию 4, 5, 8) с реконструкцией желчеотведения от задних сегментов печени, мезогепатэктомию с анатомической резекцией S6 и атипичной резекцией S2, 3. Послеоперационные осложнения класса (степени) IIIа по Dindo–Clavien развились у 1 пациента. Сосудистых осложнений и печеночной недостаточности не было. Продолжительность госпитализации варьировала от 9 до 14 дней. Медиана наблюдения составляет 8 мес (7–14 мес). Общая и безрецидивная выживаемость на момент написания работы составляет 100%.

Заключение

Заключение. Резекция центральных сегментов печени у детей осуществима; операции следует выполнять в центрах, имеющих опыт хирургии печени.

Aim

Aim. To analyze the short-term outcomes of сentral segments liver resection in children, according to the initial experience.

Мethods

Мethods. The data of patients with different centrally located liver neoplasms were analyzed. This retrospective study included three patients with hepatoblastoma, one observation of mesenchymal hamartoma of the liver and one patient with hepatocellular carcinoma. Different types of central liver resections were carried out in these patients between March and October 2018. The technical aspects and the short-term results are described.

Results

Results. Median age of patients was 78 months (9 months – 12 years). Patients underwent: segmentectomy 4b, bisegmentectomy 4b, 5, threesegmentectomy 4, 5, 6, mesohepatectomy (anatomical segmentectomy 4, 5, 8) with biliary reconstruction for posterior liver segments, mesohepatectomy with anatomical segmentectomy 6 and atypical S2, 3 resection. Dindo–Clavien grade IIIa postoperative complication developed in one patient. Vascular complications and posthepatectomy liver failure were absent. The hospital stay ranged between 9 to 14 days. The median follow-up period came to 8 months (7–14 months). The overall and event free survival at the time of writing is 100%.

Conclusion

Conclusion. Resections of central liver segments in children are feasible and should be carried out in experiences in liver surgery centers.

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The authors declare that there are no conflicts of interest present.