肝细胞癌合并门静脉癌栓外科治疗的疗效观察

Results of Surgical Treatment for Hepatocellular Carcinoma with Portal Vein Tumor Thrombi

目的探讨肝细胞癌合并门静脉癌栓(PVTT)外科治疗的效果。方法对156例肝细胞癌合并门静脉主干或第一分支癌栓的患者,均行肝癌联同门静脉癌栓切除或取栓,其中94例患者术后行肝动脉和(或)门静脉化疗。结果术后3例死于肝功能衰竭,2例死于术后并发症,余术后恢复良好,术后1、3、5年生存率分别为58.1%(86/148)、18.9%(28/148)、5.4%(8/148)。结论肝切除和门静脉切开取栓术是肝细胞癌合并PVTT的有效治疗方法,术后联合肝动脉和(或)门静脉化疗能提高治疗效果,延长患者的生存期。

Objective To study the therapeutic effects of surgical treatment for hepatocellular carcinoma （HCC） with portal vein tumor thrombi （PVTT）. Methods 156 cases of HCC with portal vein tumor thrombi underwent hepatic resection with removal of tumor thrombi in the main trunk or the first branch of the portal vein. Of all patients,94 cases received postoperative transhepatic arterial chemoembolization and/or portal vein chemotherapy. Results 3 cases died from the functional failure of liver after operation ,2 cases died from surgical complications. The remain patients recovered well. The 1 - ,3 - , and 5 -year survival rates were 58.1% （86/148）, 18.9% （28/148） and 5.4% （8/148）, respectively. Conclusion Hepatic resection with removal of tumor thrombi in the portal vein is effective in the treatment for HCC with PVTF, and postoperative transhepatic arterial chemoembolization and/or portal vein chemotherapy may have a favorable effect on the prognosis.