ATYPICAL RADICAL LIVER RESECTION IN HEPATOBLASTOMA

Five consecutive patients (age at presentation 2 1/2-30 months) with h epatoblastoma during a 4-year period are reported. The youngest died d ue to uncontrolled spontaneous hepatic bleeding prior to any treatment . After considerable tumor shrinkage was achieved by preoperative comb ined chemotherapy (doxorubicin and cisplatinum), an atypical liver res ection with ultrasound knife equipment (USK) was successfully carried out in four patients, all of whom were discharged from the pediatric s urgical department free of symptoms on 4th to 10th postoperative day. No recurrences and no tumor metastases occurred following the completi on of postoperative chemotherapy. Atypical liver resection with USK is a safe surgical modality that allows the liver parenchyma to be crush ed while leaving the bile ducts and vessels intact. These structures c an be identified and divided separately. Complete tumor removal from t he parenchyma can be performed radically regardless of the surgical re sectability as defined by the anatomic borders of the liver segments.