Phẫu thuật điều trị u gan ở trẻ em

Childhood liver tumors are usually quite large at the time of diagnosis, making their surgical treatment challenging. From December 2004 to October 2011, 75 children were operated for liver tumor at Surgical Department, National Hospital of Pediatrics, Hanoi, Vietnam. There were 41 boys and 34 girls (45.3 percent), with mean age of 36 + or - 44 months (range: 1 month - 16 years). Mean size of the tumors was 8.1 + or - 2.7cm (range: 3.5-15 cm). The most common pathologic types were hepatoblastoma - 52 patients (69.3 percent), mesenchymal hamartoma - 10 patients (13.3 percent) and hepatocellular carcinoma - 8 patients (10.7 percent). Liver biopsy was done in 23 patients (30.7 percent) and liver resection - in 52 (69.3 percent). Major liver resection (hemihepatectomy or extended hemihepatectomy) was performed in 25 patients (48.1 percent). Mean operative time for liver resection was 182 + or - 83 minutes (range: 60 - 390 minutes). There was no mortality or complication but one patient with prolonged postoperative perihepatic fluid collection, resolved by medical treatment. Mean postoperative stay in surgical department was 5.7 + or - 2.9 days. Our results shows that hepatoblastoma is the most common liver tumor indicated for surgery in children. Hepatic resections for treatment of pediatric liver tumor can be done with minimal complication and without mortality in experienced centers.