الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
H
epatocellular carcinoma (HCC) is the fifth-most common cancer globally and the third highest cause of cancer-related death exceeded only by cancers of the lung and stomach.1 It is estimated that 782,000 new cases are diagnosed with HCC annually and 600,000 die of this tumor globally each year.2 Therapeutic treatment modalities are available for patients with local disease including ablation, liver resection, and liver ransplantation (LT). However, for those with respectable tumor and without an underlying liver disease, liver resection offers the best treatment.3
Based on Couinaud’s segmental anatomy of the liver, centrally located HCC is defined as tumors located in the middle part of the liver (segments IV, V, or VIII ± I).4 For those with a centrally located HCC, the two types of liver sectionectomy that can be performed are, firstly: a major hepatectomy (MH) or an extended hepatectomy (EH) which includes a right/left hemihepatectomy or right/left trisectionectomy and secondly: a central hepatectomy (CH) which involves a left medial sectionectomy, right anterior sectionectomy, or central bisectionectomy (mesohepatectomy).
Our meta-analysis showed that the overall incidence of complications was comparable between the two modalities. However, on one hand, the incidence of post-operative liver cell failure was significantly higher in those who underwent major hepatectomy. This could be attributed to the fact that major hepatectomy is associated with the removal of 60–85% of liver parenchyma.6,7 On the other hand, a higher incidence of biliary fistula was detected for those who underwent central hepatectomy.
CONCLUSION
T
his study showed no significant difference in the short and long term survival and recurrence between CH and MH for CL-HCC. However, CH is associated with greater future remnant liver volume that decrease the incidence of LCF and provides more opportunities for a repeat hepatectomy after tumor recurrence.