原发性肝癌极量肝切除的确定

The Judgement on Extended Lobectomy for Primary Liver Cancer

目的 探讨原发性肝癌 (简称肝癌 )患者行极量肝切除的指征和安全性。 方法 2 0 0 0年11月至 2 0 0 2年 10月行极量肝切除治疗原发性肝癌共 3 3例 ,合并肝硬化者 2 6例 ,分析评估肝癌极量肝切除的术前各项指标、术中处理和术后恢复情况。 结果 全组无手术死亡 ,术后并发症发生率为 3 3 .3 % ,经及时治疗后均顺利恢复。 结论 肝脏储备功能良好的肝癌患者 ,在保证切肝量不超过肝组织量的 5 0 %的基础上 ,尽可能多地保留肝组织 ,术后加强残肝功能保护 ,及时处理并发症 。

Objective To explore the indications and safety of extended lobectomy for primary liver cancer. Methods From November 2000 to October 2002, 33 patients with primary liver cancer were performed extended hepatectomy. Twenty-six patients were incorporated with liver cirrhosis. The results of preoperative studies, methods of intra-operative management, postoperative recovery were analyzed and evaluated. Results None of the patients died from the operation. Postoperative complications occurred in 33.3% of the patients and were controlled eventually. Conclusion Extended lobectomy for primary liver cancer could be safe and feasible in the patients with enough reserve of the liver function provided that the size of the remnant liver is not less than half of the original and the liver supporting treatment is strengthened.