Extended liver resection in children under circulatory arrest and "low flow" cardiopulmonary bypass

In order to perform resections of tumors at critical sites in the liver in young children, liver resections in cardiac arrest and deep hypothermia und er cardiopulmonary bypass have been developed. We report our experience wit h liver resection under cardiopulmonary bypass in three children with hepat oblastoma. In the first child the operation was performed under cardiac arr est and, the other two children were operated on under "low flow" condition s. The periods under cardiopulmonary bypass circulation were well tolerated . Extended right liver resections with vascular reconstructions were perfor med. The postoperative increase of liver enzymes was moderate. The increase in GOT was between 100 and 200 U/l. In spite of the extended tumor growth, reasonable long-term results were achieved by resection in combination wit h chemotherapy. One child has been living 8 years and another 10 months wit hout tumor recurrence. The third child died due to sepsis during adjuvant c hemotherapy, after she had recovered well from liver resection.