经胸单切口肝癌并肺转移癌切除术的探讨(18例分析)

Single-incision thoracotomy for primary liver cancer and lung metastasis

目的分析我院1993-2003年间收治的18例巨块型原发性肝癌,经肝动脉的联合介入化疗栓塞(TACE)治疗后出现肺转移的病人。总结经胸单切口同期切除肝癌并肺转移癌的体会。方法及结果选择18例均为巨块型肝癌病人,经TACE治疗,出现同侧孤立性肺转移病灶,其中右肝癌并右肺转移11例,左肝癌左肺转移7例。经右侧开胸一切口行肝癌及肺转移瘤同期切除11例,经左侧开胸行肝癌及肺转移瘤同期切除7例。全组手术经胸切口一次完成,无需分期手术,过程顺利,无重大并发症,无手术死亡。结论该术式可同期一次完成胸腹部病灶的切除,无需分期经胸腹部两切口手术,无需改变体位,手术快捷、安全、出血少、创伤小,可减轻病人经济及心理负担,值得临床推广。

Objective To summarize the experience in treatment of 18 patients with primary liver cancer （PLC） and lung metastasis （LM） after TACE from 1993 to 2003 in our hospital. Methods Eighteen cases of PLC and LM after TACE were chosen for the study. Of the 18 patients, 11 were with the right-side PLC and right-side LM and 7 with left-side PLC and left-side LM. One-incision thoracotomy was performed on the right side for the former 11 patients and on the left for the latter 7 to simultaneously remove the PLC and LM. Results There were no needs for staged operations and the one-incision thoracotomy was successfully performed. Meanwhile, there were no serious complications and death. Conclusions The operation can remove two parts of the cancer in liver and lung simultaneously. It is worthy of being popularized because it is simple, safe, of less operative bleeding and invasion.