巨大肝癌的外科治疗分析（附63例报告）  

Analysis of surgical treatment of huge primary liver cancer：report of 63 cases

作　　者：江斌[1] 曾少波[1] 廖佳建[1] 满泉[1] 

机构地区：[1]湖北医药学院附属太和医院肝胆外科,十堰442000

出　　处：《临床外科杂志》2014年第3期167-168,共2页Journal of Clinical Surgery

摘　　要：目的 探讨巨大肝癌外科治疗的安全性和可行性.方法 63例肝癌行Ⅰ期肝切除术58例,Ⅱ期肝切除术5例;其中规则性右半肝切除术8例,左半肝切除术5例,联合肝段切除术50例.术前肝动脉化疗栓塞（TACE）5例,全肝、患侧半肝、第一肝门、无血流阻断切肝术分别为3例、6例、48例、6例.结果 术中行门静脉,肝静脉及胆管（右侧肝管）癌栓取出术分别为8例,1例,1例.63例术后均恢复顺利,术后1年生存率达80.9%（51/63）.结论 术前充分评估、术中仔细探查以及手术者的技术水平对确保巨大肝癌手术治疗的安全可行性起关键作用.Objective To explore the safety and feasibility of surgical treatment for huge primary liver cancer（HPLC）. Methods Among the 63 cases,57 cases of HPLC were complicated with HBV cir- rhosis, and 1 was with HCV cirrhosis; there were tumor thrombus in portal vein in 8 cases, hepatic vein in 1 case and bile duct in 1 case, respectively;there were 58 cases of primary hepatectomy and 5 cases of sec- ondary hepatectomy including regular right hemihepatectomy （ 8 cases） ,left hemihepatectomy （ 5 cases） and combined hepatectomy（50 cases）. Five cases received TACE before surgery. There were 3 cases of total,6 cases of hemi-,48 cases of first portal, and 6 cases of non-hepatic vascular exclusion. Results There were 8,1 and 1 cases of cancer thrombus extraction from portal vein, hepatic vein and bile duct respectively. All 63 patients were cured. The postoperative 1-year survival rate of the patients was 80.9% （51/63）. Conclusion Surgical treatment for HPLC is safe and feasible in which full preoperative assessment, careful intraoperative exploration and surgical skill play a key role.

关 键 词：肝癌 治疗 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]