腹腔镜同期手术治疗肝癌合并门脉高压性脾功能亢进的回顾性研究  

Retrospective Analysis of Homochronous Laparoscopic Surgery Treatment for Primary Hepatic Carcinoma with Hypersplenism Secondary to Portal Hypertension

作　　者：杨岳[1] 陈学敏[1] 孙冬林[1] 江勇[1] 朱峰[1] 张悦[1] 

机构地区：[1]苏州大学附属第三医院肝胆外科,江苏常州213003

出　　处：《农垦医学》2016年第5期392-394,共3页Journal of Nongken Medicine

摘　　要：目的：探讨肝癌合并门脉高压性脾功能亢进的同期腹腔镜手术治疗的安全性及疗效。方法：回顾分析我院2013年1月至2016年3月期间收治的17例肝癌合并门脉高压患者的临床资料。观察患者手术时间、术中出血量、术后住院天数及并发症发生情况。结果：17例患者施行同期腹腔镜肝脾联合切除术，其中6例加行门奇静脉断流术，1例中转开腹手术。手术时间（204±41．39）min（140-310min），术中出血（262±81．65）mL（130-390mL）。术后住院时间（8．7±1．81）d（7—15days）。术后病理证实，16例肝细胞性肝癌，1例胆管细胞癌，肿瘤切缘均为阴性，脾脏呈淤血性肿大。门诊及电话随访6—36月，肝脏肿瘤复发1例，上消化道再次出血死亡1例，失访1例。结论：同期腹腔镜手术治疗肝癌合并门脉高压性脾功能亢进安全有效，但长期疗效及临床推广仍需进一步观察。Objective： To investigate the safety and efficacy of homochronous laparoscopic surgery treatment for primary hepatic carcinoma with hypersplenism secondary to portal hypertension.Methods：Retrospective analysis of our hospital between January 2014 and March 2016, 17 cases admitted during the period of the clinical data of patients with hepatic carcinoma with portal hypertension. Monitoring of patients with operation time,intraoperative blood loss,hospitalization days and postoperative complications.Results：IT patients were underwent laparoscopic hepatectomy and splenectomy with the same period. Of the 17 cases with 1 patient conversion to open surgery,6 patients were treated by portal azygous disconnection additionally. The operative time was （204 ±41.39）min （range from 140 to 310min）,intraoperative hemorrhage from（262 ±81.65）mL（range from 130 to 90mL）,and hospitalization time after operation was （8.7 ±1.81） days （range from 7 to 15 days）. Postoperative pathology confirmed 16 cases with hepatocellular carcinoma, 1 case with cholangiocellular carcinoma,congestive splenomegaly,and a negative surgical margin. Followed up after operation was 6-36 months,1 patient was recurrence,and 1 patient was death due to upper gastrointestinal bleeding.1 case was lost to follow-up.Conclusion：These results suggest that homochronous laparoscopic surgery treatment for primary hepatic carcinoma with hypersplenism secondary to portal hypertension was safe and effective. But the long-term efficacy and clinical application still needs further observation.

关 键 词：肝癌 脾功能亢进 脾切除术 肝切除术 腹腔镜 

分 类 号：R735.7[医药卫生—肿瘤]