Anatomic mesohepatectomy for the treatment of central huge hepatic tumors

Surgical resection remains the only curative option of treatment for hepatocellular carcinoma, but centrally located tumors remain problematic. Extended right or left hepatectomy removes 60% to 85% of the hepatic parenchyma and is associated with more hepatic failure. Mesohepatectomy, resection of central hepatic segments (Couinaud′s segments Ⅳ, Ⅴ, Ⅷ) and leaving the right and left segments in situ, preserves more functional hepatic tissues than extended hepatectomy. Despite its technical demands, mesohepatectomy should be considered as an alternative treatment for central huge hepatic tumors.