巨大肝癌的外科治疗分析(附86例报告)  

Analysis of surgical treatment of huge primary liver cancer:report of 86 cases

作　　者：王兴国[1] 李杰[1] 田虎[1] 滕木俭[1] 胡宗泽[1] 李兆亭[1] 

机构地区：[1]山东省千佛山医院肝胆外科,山东济南250014

出　　处：《中国现代普通外科进展》2010年第5期354-356,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨外科治疗巨大肝癌的可行性及其方法。方法:回顾性分析86例巨大肝癌的临床资料,并对外科治疗中遇到的主要困难和相应的对策进行分析总结。结果:86例肝癌患者中合并乙肝肝硬化76例,丙肝肝硬化2例。合并门静脉、肝下腔静脉(IVC)癌栓分别为10例和5例。86例中行Ⅰ期和Ⅱ期肝切除术分别为60例和26例;其中规则性右半肝和左半肝切除术分别为9例和8例、联合肝段切除术69例。术前门静脉栓塞(PVE)6例;全肝、患侧半肝、第一肝门、无血流阻断切肝术分别为10例、例、606例、例。术中行门静脉和IVC癌栓取出术分别为10例和5例。86例中治愈81例(占94.2%);围手术10期死亡5例(占5.8%)。术后1年生存率达77.9%(67/86)。结论:巨大肝癌的手术治疗是安全可行的。术前充分评估,术中仔细探查以及手术者的技术水平起关键作用。Objective：To explore the possibility and methods of surgical treatment（ST） for huge primary liver cancer（HPLC）.Methods：The clinical data of 86 HPLC were analyzed retrospectively and the main challenges as well as their counter measures during ST are concluded.Results：Among the 86 cases,there were 10 cases which complicated with portal vein（PV）,and 5 cases with IVC thrombus respectively;there were 76 cases with HBV cirrhosis,2 HCV cirrhosis,there were 60 and 26 cases of primary and secondary hepatectomy in which included regular right（9 cases）,left hemihepatectomy（8 cases）and combined hepatectomy（69 cases）.Six cases received PV embolism before surgery.There were 10 and 5 cases of cancer thrombus extraction from PV and IVC respectively.In this group,81 patients were cured,and the perioperative mortality was 5.8%（5/86）.The postoperative one—year survival rate for the patients was 77.9%.Conclusions：ST for HPLC is safe and acceptable.Full of preoperative assessment,careful intraoperative exploration,and surgical skill played a key roles.

关 键 词：肝肿瘤 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]