选择性半肝血流阻断对结直肠癌肝转移切除术后疗效的影响

Influence of selective hemihepatic blood flow occlusion on long-term survival following liver resection for metastasis of colorectai cancer

目的研究选择性半肝血流阻断方法对结直肠癌肝转移切除术后疗效的影响。方法回顾性分析1998—2006年海军总医院对71例结直肠癌肝转移病人实施手术切除的情况，比较半肝血流阻断和Pringle手法两种不同的入肝血流阻断方法对于肝转移癌的治疗效果。结果全组病人术后l，3，5年生存率为82．7％，46．2％，27．1％。采用半肝血流阻断的方法肝转移癌切除术病人的1，3，5年生存率为89．7％，54．2％，34．1％，采用Pringle手法肝门血流阻断的方法行肝转移癌切除术病人的1，3，5年分别为73．3％，41．5％，23．9％。两组1，3，5年生存率比较有显著性差异（P〈0．05）。结论与Pringle手法相比较，利用半肝血流阻断的方法行肝转移癌切除术可以有效延长病人的生存期，半肝阻断方法行转移癌切除术，是减少循环肿瘤细胞的种植与减缓生长速度的有效方法。

Objective To explore the clinical effect of selective hernihepatic blood flow occlusion in hernihepatectomy for metastasis of colorectal cancer. Methods The clinical data of 7I cases of me tastatic cancer of the liver surgically treated in our hospital from 1998 to 2006 were retrospectively an- alyzed. Surgical effect was compared between the selective hemihepatic blood flow occlusion group and the Pringle group. Results The 1-, 3 , and 5-year survival rates for all the patients were 82.7%, 46.2 % and 27.1%, respectively. They were 89.7 %,54.2 %, 34.1% in the selective hemihepatic blood flow occlusion group and 73.3 %,41.5 %, 23.9 % in the Pringle group, respectively. There were sig- nificant differences between the 2 groups （P〈0.05）. Conclusion The hepatectorny for the metastasis in the liver of colorectat cancer by hemihepatic blood flow occlusion is a more effective procedure to prolong the long-term survival than by Pringle procedure.