介入治疗原发性肝癌移植术后复发的价值

Value of interventional treatment of recurrence primary live cancer after liver transplant

目的探讨原发性肝癌肝移植术后复发患者的临床表现及介入治疗价值。方法 2004年3月~2011年6月14例肝移植术后复发的肝癌患者行综合介入治疗,包括肝动脉化疗栓塞32次、肝动脉泵置泵1例、经皮肝穿刺胆道引流1例、经内镜逆行性胰胆管造影术1例,高强度聚焦超声1例。结果肝癌复发灶呈肝内多发、肝外广泛转移的特点,多为富血供肿瘤,合并血管及胆管并发症者各2例;接受介入治疗后至今存活2例,12例从接受肝移植治疗到死亡平均生存16.1个月。结论原发性肝癌肝移植术后采用介入治疗可有效抑制肝癌术后复发灶及转移灶的生长,消除移植术并发症对患者的危害,延长患者的生存时间并提高生活质量。

Objective To explore performance and value of interventional treatment in recurrence primary liver cancer after liver transplantation. Methods The interventional treatment were performed in 14 recurrence primary liver cancer cases, treatment methods included transcatheter arterial chemoembolization 32 times in 14 cases, placement of hepatic artery pump in 1 case, percutaneous transhepatic cholangial drainage and endoscopic retrograde cholangio-pancreatography in 1 case respectively, high intensity focused ultrasound in 1 case. Results Recurrence showed multiple lesions in liver and extrahepatic metastasis, mostly had rich blood supply, 2 cases had vascular complications and 2 cases had biliary complications; 2 cases was still alive. For other 12 cases, from liver transplantation therapy to death, the survival time was 16.1 months. Conclusions Interventional treatment can effectively inhibited the growth of recurrent lesions after transplantation, which decrease the hazards of transplantation complications for patients and improve the curative effect for tumor, thus improve the quality of life.