原发性肝癌的手术治疗(附128例分析)

SURGICAL TREATMENT OF PRIMARY LIVER CANCER:ANALYSIS OF 128 CASES

本文对我院外科自1961年1月~1980年12月收治的128例原发性肝癌手术切除病例进行疗效分析。手术切除率为27.8%,手术死亡率为4.6%,术后一至五年生存率分别为60.2%、34.7%、26.0%、22.1%、16.2%。肝硬化程度、肝切除量与手术死亡有关。对肝硬化严重患者应严格掌握肝切除指征,以降低手术死亡率.不伴肝硬化、癌灶为单中心、肿瘤包膜完整,门脉内无癌栓、癌周肝组织地衣红染色阴性者,经根治性切除术后生存期较长。在作根治性手术的原则下不放弃姑息性手术.应放宽临床Ⅰ期肝癌的探查指征,以增加肝切除的可能。

The results of resection of primary liver cancer in 128 cases from Jan 1961 through1980 were analysed.In this series,the resection rate was 27.8%,operative mortality4.6%and 1-5 years survival rates 60.2%,34.7%,26.0%,22.1%and 16.2%,respectively.The severity of cirrhosis and the amount of liver tissue resected wereclosely related to operative mortality,so that hemihepatectomy in cases with severecirrhosis should be restricted,especially the right hemihepatectomy.Also it is veryimportant to preserve as much as possible the normal liver tissue during radical resec-tion.Patients without cirrhosis,without tumor emboli in portal vein and with tumorsencapsulated lived longer after resection.