改良背驮式肝移植在原发性肝癌治疗中的价值

Value of ameliorated piggy-back liver transplantation in primary hepatocarcinoma

目的探讨改良背驮式肝移植(ameliorated piggy-back liver transplantation,APBLT)治疗原发性肝癌(primary hepatocarcinoma,PHC)的临床疗效。方法回顾性分析了1995年9月至2006年1月间实施肝移植治疗的166例PHC患者临床经过,统计术后1年、3年生存率、肿瘤复发率以及复发时间。结果APBLT术后1年、3年生存率分别为56.6%、37.9%;术后肿瘤复发率为45.8%,中位复发时间为(338±78)d,与大的移植中心所报道的大宗PHC原位肝移植病例随访数据相近。结论APBLT是治疗PHC的有效手段;手术方式不是影响移植术后预后的关键因素,PHC肝移植手术方式的选择应根据术者的经验以及对术式的熟悉程度而定。

Objective To explore the clinical curative effect of ameliorated piggy-back liver transplantation （APBLT） in the treatment of primary hepatocarcinoma （PHC）. Methods The treatment processes of 166 cases of PHC underwent the APBLT during September 1995 to January 2006 were analyzed retrospetively. 1,3 year＇s postoperative survival rates and 1 year＇s postoperative tumor recurrent rates were analyzed. Results Of 166 cases underwent APBLT, the 1, 3 year＇s survival rates were 56. 6% , 37.9% respectively;the tumor recurrent rate was 45.8% and the median recurrent time was 338 ± 78 days. Conclusions APBLT is an effective therapy for PHC. The difference of procedures is not the key point to affect the prognosis of transplantation and the selection of procedures depends on the experience and proficiency of the operators.