经导管肝动脉化疗栓塞后二期切除治疗肝癌(附16例分析)

HEPATECTOMY FOR THE TREATMENT OF LIVER CANCER FOLLOWING TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION: A REPORT OF 16 CASES

目的 提高外科治疗肝癌的生存率。方法 1 995年 3月— 2 0 0 1年 6月 ,我院收治肝癌 91例 ,其中经导管肝动脉栓塞(TACE)后切除 1 6例。结果 发现TACE后肿瘤的变化以坏死为主 ,坏死程度与TACE次数呈正相关 ,TACE后不能使肿瘤完全坏死。结论 单纯TACE不能彻底治愈肝癌 ,应在末次TACE后 2～ 4月后立即切除。对于能够手术切除的病例 ,不宜常规术前TACE。

Objective In order to improve the survival of liver cancer. Methods A total of 91 patients with primary liver cancer have been treated, of which 16 cases had a hepatectomy after the transcatheter arterial chemoembolization (TACE). Results Our data revealed that the pathohistological changes of the tumor after TACE is dominated by necrosis that is in degree positively correlated with the times of TACE. It is indicated that TACE could not completely destroy the tumor tissues. Conclusion It is concluded that the hepatectomy should be performed 2 and 4 months after the end time of TACE because of the TACE ability to control the tumor completely. If the hepatectomy is indicated, it is not suitable to make the TACE preoperatively routinely.