原发性肝癌合并门静脉、下腔静脉癌栓的肝叶切除术

Hepatectomy for Primary Liver Cancer with Tumor Thrombi of Portal Vein or Inferior Vena Cava

对１３例有门静脉汇合部及主干癌栓和２例有肝后段下腔静脉癌栓的肝癌施行肝叶切除，并在入肝血流阻断或全肝血流阻断下清除了门静脉、下腔静脉癌栓。６例于门静脉和（或）肝动脉置管化疗。全组无手术死亡，手术后半年、１年、２年的生存率分别为８０％、４０％、１３％，延长了病人生存期。作者对癌栓摘除的病理基础、适应证、手术方法及意义进行了讨论。

From January 1985 to June 1996, hepatectomy and tumorthrombectomy were performed under transient blockage of hepatic blood inflow or complete blockage of hepatic blood flow on 13 cases of primary hepatic cancer with tumor thrombi at the confluence and trunk of the portal vein, and another 2 cases with tumor thrombus in the posterior segment of inferior vena cava.Six cases received transcatheteral chemotherapy. There was no operative mortality. The postoperative 1/2, 1, 2year survival rates were 80%,40%,13% respectively with prolonged survival. The pathological basis of tumorthrombectomy, indications and operative procedure were discussed. 