肝细胞癌合并门静脉、肝静脉或下腔静脉癌栓的处理

Management of tumor thrombi in hepatocellular carcinoma with tumor thrombi in portal vein, hepatic vein or inferior vena cava

目的探讨肝细胞癌（HCC）合并门静脉（PV）、肝静脉或下腔静脉（IVC）癌栓的处理。方法总结1993年1月-2002年1月采用肝切除和癌栓取出术治疗HCC合并PV、肝静脉或IVC癌栓68例，其中PV癌栓63例，肝左静脉癌栓1例，肝中静脉癌栓合并PV左支癌栓1例，肝右静脉、IVC合并PV右支癌栓1例，IVC癌栓2例。结果6例患者术后3个月内死于肝肾功能衰竭，其中2例患者在术后30d内死亡，术后30d病死率为2．9％，其余62例患者术后恢复良好。结论肝切除和癌栓取出术治疗HCC合并PV、肝静脉或IVC癌栓是安全的。

Objective To explore the management of tumor ihrombi in hepatocellular carcinoma （HCC） with tumor thrombi in portal vein, hepatic vein or inferior vena cava. Methods From January 1993 to January 2002, 68 patients of HCC with tumor thrombi in portal vein, hepatic vein or inferior vena cava underwent hepatic resection with tumor thrombectomy. Among them, 63 patients had portal vein tumor thrombi, 1 patient had left hepatic vein tumor thrombi, 1 patient had middle hepatic vein and portal vein left branch tumor thrombi, 1 patient had right hepatic vein, inferior vena cava and portal vein right branch tumor thrombi, 2 patients had inferior vena cava tumor thrombi. Results Six patients died of liver and kidney function failure in 3 months postoperatively, 2 of them died within 30 days postoperatively, and the mortality was 2.9% during this time. The other 62 patients recovered in good state. Conclusion Hepatic resection with tumor thrombectomy is safe in treatment for HCC with tumor thrombi in portal vein, hepatic vein or inferior vena cava.