前入路联合肝下下腔静脉阻断切除右肝巨大肝细胞癌  

Anterior approach combined with infrahepatic inferior vena cavaclamping hepatic resection for right huge(>10 cm)hepatocellular carcinoma

作　　者：吴路鹏[1] 冯柳兴 刘育键 周彦明[1] 

机构地区：[1]厦门大学附属第一医院肝胆胰血管外科,厦门361000

出　　处：《肝胆外科杂志》2017年第4期292-294,共3页Journal of Hepatobiliary Surgery

摘　　要：目的探讨入前入路联合肝下下腔静脉阻断在右肝巨大肝细胞癌(>10 cm)切除术中的安全性和有效性。方法回顾分析2012年1月至2017年4月间采用前入路联合肝下下腔静脉阻断治疗右肝巨大肝细胞癌的42例病人的临床资料。结果 42例患者平均下腔静脉阻断时间38.5分钟。肝下下腔静脉阻断后中心静脉压对比阻断前明显降低(4.1±2.1cm H_2Ovs.7.3±2.5cm H_2O,P<0.05),术中平均出血量为430.6±260.7 ml。输血率、术后并发症和死亡率分别为26.1%、38.1%和0%。结论前入路联合肝下下腔静脉阻断治疗右肝巨大肝细胞癌有效、安全。Objective To evaluate the safety and potential benefit of anterior approach combined with infrahepatic inferior ve- na cava （IVC） clamping hepatic resection for right huge （ 〉 10 cm） hepatocellular carcinoma （HCC）. Methods Clinical data of pa- tients with roght huge HCC underwent anterior approach combined with infrahepatic IVC clamping hepatic resection from January 2012 to April 2017 were retrospectively reviewed. Results Tthe mean occlusion time of the infrahepatic [VC clamping was 38.5min. The CVP was significantly lower after infrahepatic IVC clamping during parenchymal transection （4.1 ±2. 1 cm H20 vs. 7.3± 2. 5 cm H20, P 〈 0.05 ）. Total intraoperative blood loss was about 430.6± 260.7 ml. Transfusion, mortality, and morbidity rates were 26. 1%, 38. 1% and 0%, rspectively. Conclusion Anterior approach combined with infrahepatic IVC clamping hepatic resection for right huge HCC is a safe and effective technique.

关 键 词：肝下下腔静脉阻断 前入路 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤]