同时性肝细胞癌和食管鳞状细胞癌1例MDT讨论  

MDT discussion of a case of simultaneous multiple primary cancer-hepatocellular carcinoma and esophageal squamous cell carcinoma

作　　者：覃智 覃勇辉 廖锦元[2] 杨红[3] 曾智明[4] 王永勇[5] 王继龙 徐邦浩[1] 郭雅[1] 彭涛[1] 彭民浩[1] 文张[1] QIN Zhi;QIN Yonghui;LIAO Jinyuan;YANG Hong;ZENG Zhiming;WANG Yongyong;WANG Jilong;XU Banghao;GUO Ya;PENG Tao;PENG Minhao;WEN Zhang(Department of Hepatobiliary Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region 530021,P.R.China;Department of Radiology,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region 530021,P.R.China;Department of Doppler Ultrasonic,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region 530021,P.R.China;Department of Oncology,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region 530021,P.R.China;Department of Thoracic Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region 530021,P.R.China)

机构地区：[1]广西医科大学第一附属医院肝胆外科,广西南宁530021 [2]广西医科大学第一附属医院放射科,广西南宁530021 [3]广西医科大学第一附属医院超声科,广西南宁530021 [4]广西医科大学第一附属医院肿瘤内科,广西南宁530021 [5]广西医科大学第一附属医院胸外科,广西南宁530021

出　　处：《中国普外基础与临床杂志》2020年第12期1561-1567,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金地区科学基金项目(项目编号:81560387);国家自然科学基金青年科学基金项目(项目编号:81902983);广西自然科学基金青年科学基金项目(项目编号:2018GXNSFBA050030);广西医疗卫生适宜技术开发与推广应用项目(项目编号:S2019097);广西医疗卫生适宜技术开发与推广应用项目(项目编号:S2018100)。

摘　　要：目的探讨同时性多原发癌——肝癌和食管癌行手术治疗的安全性和可行性。方法回顾性分析2019年4月广西医科大学第一附属医院收治的1例同时性多原发肝癌和食管癌患者的临床资料。结果患者入院诊断为肝细胞癌和食管癌,经多学科会诊,分期行前入路右半肝切除+胆囊切除术和食管癌根治术。前入路右半肝切除+胆囊切除手术过程顺利,手术时间270 min,术中出血量500 mL,术后恢复顺利,术后病理学检查提示肝细胞癌Ⅱ级;食管癌根治手术过程顺利,手术时间176 min,术中出血量100 mL,术后无相关外科并发症发生,术后病理学检查提示食管中分化鳞状细胞癌。患者于肝癌根治术后13个月、食管癌术后10个月随访,一般情况可,伤口愈合良好,无肿瘤复发。继续随访。结论针对同时性多原发肝癌和食管癌,通过联合多学科诊疗对患者的多原发癌部位、病理分期、全身情况等进行评估后,再分期施行根治术是安全和可行的。Objective To explore the safety and feasibility of surgical treatment of simultaneous multiple primary cancer–hepatocellular carcinoma and esophageal squamous cell carcinoma.Method The clinical data of one patient with simultaneous multiple primary cancer of hepatocellular carcinoma and esophageal squamous cell carcinoma,who treated in the First Affiliated Hospital of Guangxi Medical University in April 2019 was analyzed retrospectively Results The patient was diagnosed as hepatocellular carcinoma and esophageal squamous cell carcinoma on admission.After MDT in the hospital,the patient underwent anterior right hepatectomy+cholecystectomy and radical resection of esophageal carcinoma in turn.The procedure of anterior right hepatectomy+cholecystectomy was smooth,the duration of the surgery was 270 min,and the total blood loss was 500 mL,and postoperative pathology showed that hepatocellular carcinoma was in gradeⅡ.The operation process of radical resection of esophageal cancer was smooth too,the duration of the surgery was 176 min,and the total blood loss was 100 mL,and postoperative pathology showed moderately differentiated squamous cell carcinoma.No related surgical complications occurred after the operation.Thirteen months after the operation of liver cancer and 10 months after the operation of esophageal cancer,the patient was generally in good condition,well wound healing,and no clinical recurrence.The follow-up of the patient was continued.Conclusion In allusion to simultaneous multiple primary cancers,it is safe and feasible to evaluate the location,pathological stage,and general condition of the patient by combining multi-disciplinary diagnosis and treatment and then performing radical operations in turn.

关 键 词：同时性多原发癌 肝细胞癌 食管鳞状细胞癌 MDT 手术 

分 类 号：R735.7[医药卫生—肿瘤] R735.1[医药卫生—临床医学]