原发性肝癌切除术后复发的肝移植治疗  

Liver transplantation for the recurrence after resection of liver cancer

作　　者：杨宁[1] 杨广顺[1] 邵卓[1] 卢军华[1] 张海斌[1] 王鑫[1] 司马辉[1] 吴田田[1] 李团结[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院,上海200438

出　　处：《中国实用外科杂志》2007年第3期217-220,共4页Chinese Journal of Practical Surgery

基　　金：上海市科委重大项目<多种脏器移植的临床研究>资助;项目编号:024119001

摘　　要：目的探讨原发性肝癌切除术后复发病人的肝移植手术指征和注意事项。方法总结2003年7月至2005年8月59例因肝癌接受肝移植的临床资料,其中肝癌切除术后复发12例(复发组),移植术前未接受手术治疗47例(对照组),分析两组病人移植术前肝功能、治疗情况、术中探查、手术时间、无肝期时间、出血量以及术后恢复情况。结果复发组病人移植手术时间、术中出血量及输血量均明显大于对照组,但两组无肝期时间以及1、2年存活率(75%vs.86%,P>0.05;70.8%vs.83.3%,P>0.05)差异无显著性意义。结论肝移植是肝癌切除术后复发病人的有效治疗方法,合理掌握肝移植指征是治疗肝癌切除术后复发的关键。Objective To study the indication and announcement of liver transplantation for the patients underwent recurrence after resection of liver cancer. Methods The clinical data of 59 patients performed liver transplantation because of primary liver cancer between July 2003 and August 2005 was analyzed. Among them, 12 patients （recurrent group） underwent recurrence after tumor resection, while the other 47 patients （ control group） had not undergone surgical operation. Their hapatic functions before liver transplantation, treating state, exploration during the operation, the duration of the opertion and anhepatic phase, the volume of blood loss and the healing condition were compared between two groups. Resuits The duration of the operation, the volume of blood loss and blood transfusion during operation in recurrent group were greater than those in control group significantly, but there was no significant difference in anhepatic phase and 1 - year （75% vs. 86%, P 〉0. 05） and 2-year survival rate （70. 8% vs. 83.3%, P 〉0. 05） between two groups. Conclusion Liver transplantation is an effective therapy for the patients underwent recurrence after radical resection of liver cancer. The key point to treat these patients is to utilize the indications for liver transplantation reasonably.

关 键 词：肝癌 肝切除术 肝移植 

分 类 号：R6[医药卫生—外科学]