Abstract：
The surgical management of perihilar carcinoma (pCCA) is still subject of ongoing debate. To provide more clarity, this study was conducted to evaluate outcomes related to the side and extent of heatectomy in patients with pCAA.
A total of 32 patients with curative resection for pCCA were identified from our prospective database. Short-and long-term clinical outcome data and histopathological results were compared between right-sided (R-H) and left-sided (L-H) hepatectomy.
Nine patients (28.13%) underwent left-sided hepatectomy while a right-sided hepatectomy was accomplished in 23 patients (71.87%). In the R-H group hepatic conditioning of the future liver remnant (FLR) prior to extended resection was necessary in 13 cases (56.52%), and simultaneous pancreaticoduodenectomy was performed in 5 patients (21.74%). The arterial and portal venous reconstruction rates were 17.39% and 11.11% (P=1.00), and 60.87% and 33.33% (P=0.243) in the R-H and L-H groups, respectively. No statistically significant differences in short-term morbidity and mortality between both groups were observed. The rate of R0 resections was comparable (R-H: 78.26% versus L-H: 66.67%; P=0.654) resulting in similar long-term overall and disease-free survival rates after right-and left hepatectomy.
In patients with pCCA, both right- and left-sided resections appear to be safe and feasible options with similar postoperative morbidity and oncologic outcomes. Consecutively, the ideal surgical approach should be patient-tailored based on anatomical considerations and the functional future liver capacity.
A total of 32 patients with curative resection for pCCA were identified from our prospective database. Short-and long-term clinical outcome data and histopathological results were compared between right-sided (R-H) and left-sided (L-H) hepatectomy.
Nine patients (28.13%) underwent left-sided hepatectomy while a right-sided hepatectomy was accomplished in 23 patients (71.87%). In the R-H group hepatic conditioning of the future liver remnant (FLR) prior to extended resection was necessary in 13 cases (56.52%), and simultaneous pancreaticoduodenectomy was performed in 5 patients (21.74%). The arterial and portal venous reconstruction rates were 17.39% and 11.11% (P=1.00), and 60.87% and 33.33% (P=0.243) in the R-H and L-H groups, respectively. No statistically significant differences in short-term morbidity and mortality between both groups were observed. The rate of R0 resections was comparable (R-H: 78.26% versus L-H: 66.67%; P=0.654) resulting in similar long-term overall and disease-free survival rates after right-and left hepatectomy.
In patients with pCCA, both right- and left-sided resections appear to be safe and feasible options with similar postoperative morbidity and oncologic outcomes. Consecutively, the ideal surgical approach should be patient-tailored based on anatomical considerations and the functional future liver capacity.
摘要：
背景：肺门周围癌（pCCA）的外科治疗仍是争论的主题。为了更清晰，本研究旨在评估pCAA患者热切除术的侧面和程度相关结局.
方法：从我们的前瞻性数据库中确定了总共32例pCCA根治性切除患者。比较右侧（R-H）和左侧（L-H）肝切除术之间的短期和长期临床结果数据和组织病理学结果。
结果：9例（28.13%）接受了左侧肝切除术，而23例（71.87%）接受了右侧肝切除术。在R-H组中，有13例（56.52％）需要在扩大切除前对将来的肝残块（FLR）进行肝脏调理，5例(21.74%)同时行胰十二指肠切除术。动脉和门静脉重建率分别为17.39%和11.11%(P=1.00),R-H和L-H组分别为60.87%和33.33%(P=0.243),分别。两组之间的短期发病率和死亡率无统计学差异。R0切除率相当（R-H：78.26％与L-H：66.67％；P=0.654），导致左右肝切除术后长期总体和无病生存率相似。
结论：在pCCA患者中，右侧和左侧切除是安全可行的选择,术后发病率和肿瘤结局相似.连续,理想的手术方式应根据患者的解剖学考虑和未来的肝功能量为患者量身定制.
方法：从我们的前瞻性数据库中确定了总共32例pCCA根治性切除患者。比较右侧（R-H）和左侧（L-H）肝切除术之间的短期和长期临床结果数据和组织病理学结果。
结果：9例（28.13%）接受了左侧肝切除术，而23例（71.87%）接受了右侧肝切除术。在R-H组中，有13例（56.52％）需要在扩大切除前对将来的肝残块（FLR）进行肝脏调理，5例(21.74%)同时行胰十二指肠切除术。动脉和门静脉重建率分别为17.39%和11.11%(P=1.00),R-H和L-H组分别为60.87%和33.33%(P=0.243),分别。两组之间的短期发病率和死亡率无统计学差异。R0切除率相当（R-H：78.26％与L-H：66.67％；P=0.654），导致左右肝切除术后长期总体和无病生存率相似。
结论：在pCCA患者中，右侧和左侧切除是安全可行的选择,术后发病率和肿瘤结局相似.连续,理想的手术方式应根据患者的解剖学考虑和未来的肝功能量为患者量身定制.
