累及第2肝门区巨大肝癌55例手术切除体会  

Resection of huge liver cancer involving the second porta hepatis: report of fifty-five patients

作　　者：陈汉[1] 吴孟超[1] 王义[1] 尉公田[1] 罗运权[1] 林川[1] 

机构地区：[1]第二军医大学东方肝胆外科医院,上海200438

出　　处：《中华普通外科杂志》2000年第9期524-526,共3页Chinese Journal of General Surgery

摘　　要：目的　探讨累及第 2肝门区巨大肝癌切除的可能性及手术方法。方法　 5 5例累及第2肝门区的巨大肝癌 ,平均癌灶直径 12 7cm(8～ 2 8cm) ,经右侧肋缘下或“屋顶式”切口进腹 ,充分暴露游离癌灶后在间歇性第 1肝门阻断下切除癌灶 ,切肝前预置腔静脉阻断带。结果　全组 5 5例无手术死亡。存活时间最长的 1例已达 4年无复发 ,术后 1、2、3、4年生存率分别为 6 3 %、5 0 %、5 0 %和30 %。结论　对单发肝脏巨大癌灶 ,不伴有肝硬化或肝硬化程度较轻的中青年患者 ,如癌组织生长缓慢 ,又无肝外转移时 ,虽影像学检查视为难以切除 ,但仍应争取开腹探查。Objective[WT5”BZ] To report the author′s experience on the resection and surgical technique for huge liver cancer involving the second porta hepatis usually judged as unresectable in fifty-five patients, with the tumor diameter of 8～28*!cm.[WT5”HZ]Methods[WT5”BZ] Right subcostal or “rooftop”incision was made, the liver ligments were divided,good exposure of the tumor and access to retrohepatic inferior vena cava were achieved, Hepatectomies were completed under intermittent interruption of first porta hepatis, occluding tape around vena cava was applied before liver resection if necessary. [WT5”HZ]Results[WT5”BZ] All tumors were successfully resected without inhospital death. The longest recurrence-free survival is now 4 years. The 1～4 year postoperative survival rates were 63%、50%、50% and 30% respectively. [WT5”HZ]Conclusions[WT5”BZ] Young patients with solitary large liver tumor,which grows slowly over a long period of time on basis of non-cirrhotic or mild cirrhotic liver should undergo an exploration in an attempt of resection irrespective of the image contraindication, provided that there is no extrahepatic metastases. [WT5”HZ]

关 键 词：肝癌 治疗 手术切除 

分 类 号：R735.7[医药卫生—肿瘤]