To evaluate the safety and clinical efficacy of surgical resection in patients with large liver cancer in segment Ⅷ.

Clinical data of 17 patients who underwent resection of segment Ⅷ large liver cancer from January 2008 to December 2012 in Eastern Hepatobiliary Surgery Hospital were retrospectively analyzed. Among them, 15 patients were male and 2 female, aged 30-62 years, witha median age of 49 years. The informed consents of all patients were obtained and the local ethical committee approval was received. Intraoperatively, low central venous pressure was adopted, and different vascular occlusions were reasonably applied to control the massive hemorrhage of the hepatic vein and inferior vena cava. Radical resection of the tumor was the principle of operation. Survival analysis were conducted with Kaplan-Meier method and Log-rank test.

All 17 patients underwent the operation successfully. The median operation time was 133 (80-190) min. Intraoperative blood loss was 150 (50-800) ml. Blood transfusion was performed in 3 cases (600, 800 and 600 ml). No perioperative death occurred. Postoperative complications were noted in 9 cases, including pleural effusion in 7 cases, atelectasis in 1 and peritoneal effusion combined with pleural effusion in 1. No serious complications, such as intraoperative hemorrhage and air embolism, were observed. Adjuvant TACE was performed in 16 cases after operation. The tumor-free survival time was 12 (1-116) months and the overall survival time was 30 (12-116) months. The 1-, 3-, and 5-year tumor-free survival rates were 58.8%, 40.3% and 30.3%, respectively. The 1-, 3-, and 5-year overall survival rates were 100.0%, 48.1% and 41.3%, respectively.

Hepatectomy is still the primary choice for the treatment of large liver cancer in segment Ⅷ. The main objective of operation is radical resection of tumors, which yields good clinical efficacy. Intraoperatively, hemorrhage control with different measures, to protect the main vascular structures, to avoid the hepatic vein and inferior vena cava damage, to prevent the incidence of air embolism and to properly manage the liver section, can ensure the safety of operation.