肝切除治疗原发性肝癌的评价

Evaluation of Hepatic Resection for Primary Liver Cancer

报道640例原发性肝癌作肝切除术。其中局部切除317例(49.5％),左外叶切除98例(15.3％),左半肝切除160例(25.0％),扩大左半肝切除12例(1.9％),右半肝切除49例(7.7％),扩大右半肝切除4例(0.6％)。手术死亡率为5.5％。术后1、3、5、10年生存率分别为73.1％、48.9％、38.7％、28.1％;其中210例小肝癌则分别为89.7％、77.0％、63.8％、43.5％。78例术后生存5年以上,其中30例生存10年以上。对肝切除指征、手术操作及进一步提高手术远期疗效作了讨论。

This article presents analysis of 640 hepatic resections for primary liver cancer(PLC). Local resection performed in 49.5%(317/640) of the cases,left lateral segmentectomy in 15.3% (98/640),left hemihepatectomy in 25.0%(160/640), extended left hemihepatectomy in 1.9%(12/640),right hemihepatectomy in 7.7%(49/640), and extended right hemihepatectomy in 0.6%(4/640). The overall operative mortality was 5.5%. The 1-year,3-year, 5-year,and 10-year survival rates after resection were 73.1%,48.9%,38.7%,and 28.1% respectively. Among the 210 patients with small PLC (≤5cm ), the corresponding rates after resection were 89.7%,77.0%,63.8%, and 43.5%. In the entire series, 78 patients have survived more than 5 years after resection, of them 30 patients have sur- vived more than 10 years after resection. The indication for heaptic resection, surgical technique and the improvement of surgical results are discussed.