Abstract
Liver tumours in children are rare and occur more commonly in infants. This paper reviews our experience and aspects of management important to the anaesthetist in 31 patients who had liver lobectomies. It discusses the rationale for the use of: (1) hypothermia to provide extra protection if hypotension occurs due to blood loss or vena caval occlusion; (2) induced hypotension and vasodilators to reduce bleeding and facilitate cooling; and (3) haemodilution to minimise red cell loss and improve flow during hypothermia. Bleeding is the major operative problem. There was 1 case of intraoperative pulmonary tumour embolism. Postoperatively, hypoglycaemia, hypoproteinaemia, and sepsis can be significant problems.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Akyon MG, Arslan G (1981) Pulmonary embolism during surgery for a Wilms tumour (nephroblastoma). Br J Anaest 53: 903–905
Brewin EG (1964) Physiology of hypothermia. International Anesthesiology Clinics 2: 803–828
Brown TCK (1974) Non cardiac uses of cardiopulmonary bypass. Anaest Intensive Care 2: 87
Brown TCK, Clarke CP, Shanahan EA, McKie BD, Wood HM, Thorp EA (1972) The management of infants for cardiac surgery under deep hypothermia. Anaest Intensive Care 1: 137–140
Brown TCK, Dunlop ME, Stevens BJ, Shanahan EA, Clarke CP (1973) Biochemical changes during surface cooling for deep hypothermic open heart surgery. J Thorac Cardiovasc Surg 65: 402–408
Brown TCK, Gregory M, Bell B, Campbell PC (1987) Liver tumours and muscle relaxants — electromyographic studies in children. Anaesthesia 42: 1284–1286
Davidson PM, Brown TCK, Auldist AW (1988) Elective nepatic resection in children. (submitted for publication)
Delva E, Barberousse JP, Nordlinger B, Ollivier JM, Vacher B, Guilmet C, Huguet C (1984) Haemodynamic and biochemical monitoring during major liver resection with use of hepatic vascular exclusion. Surgery 95: 309–318
Dorman F, Sumner E, Spitz L (1985) Fatal intraoperative tumor embolism in a child with hepatoblastoma. Anesthesiology 63: 692–693
Ein SH, Shandling B, Williams WG, Trusler G (1981) Major hepatic tumour resection using profound hypothermia and circulation arrest. J Pediatr Surg 16: 339–342
Main BJ, Brown TCK, Jones PG (1984) Intraoperative pulmonary tumour embolism during hepatectomy. Can Anaest Soc J 31: 117
Stone HH (1975) Major hepatic resections in children. J Pediatr Surg 10: 127–134
Author information
Authors and Affiliations
Additional information
Offprint requests to: T. C. K. Brown
Rights and permissions
About this article
Cite this article
Brown, T.C.K., Davidson, P.D. & Auldist, A.W. Anaesthetic considerations in liver tumour resection in children. Pediatr Surg Int 4, 11–15 (1988). https://doi.org/10.1007/BF00173076
Issue Date:
DOI: https://doi.org/10.1007/BF00173076