Anatomic isolated caudate lobectomy: Is it possible to establish a standard surgical flow?

AIM To establish the surgical flow for anatomic isolated caudate lobe resection. METHODS The study was approved by the ethics committee of the Second Affiliated Hospital Zhejiang University School of Medicine(SAHZU). From April 2004 to July 2014, 20 patients were enrolled who underwent anatomic isolated caudate lobectomy at SAHZU. Clinical and postoperative pathological data were analyzed. RESULTS Of the total 20 cases, 4 received isolated complete caudate lobectomy(20%) and 16 received isolated partial caudate lobectomy(80%). There were 4 caseswith the left approach(4/20, 20%), 6 cases with the right approach(6/20, 30%), 7 cases with the bilateral combined approach(7/20, 35%), 3 cases with the anterior approach(3/20, 15%), and the hanging maneuver was also combined in 2 cases. The median tumor size was 5.5 cm(2-12 cm). The median intraoperative blood loss was 600 m L(200-5700 m L). The median intra-operative blood transfusion volume was 250 m L(0-2400 m L). The median operation time was 255 min(110-510 min). The median post-operative hospital stay was 14 d(7-30 d). The 1-and 3-year survival rates for malignant tumor were 88.9% and 49.4%, respectively. CONCLUSION Caudate lobectomy was a challenging procedure. It was demonstrated that anatomic isolated caudate lobectomy can be done safely and effectively.