巨大肝癌的外科治疗:附146例报告

Surgical treatment for giant primary liver cancer:a report of 146 cases

目的 探讨巨大肝癌外科治疗的效果。方法 回顾性分析近 11年间收治的 14 6例原发性巨大肝癌的外科治疗情况。 14 6例均经手术治疗 ,其中行不规则肝切除 99例 ,半肝切除 2 8例 ,右三叶切除 4例 ,包括术前行TACE后获得二期切除 19例 ;6例同时行门静脉切开取栓术。另 15例仅行活检 +DDS ,术中行DDS治疗者 10 5例。结果 手术并发症发生率 10 .3 % ,术后 1个月内病死率1.4% ,术后 1,3 ,5年和 10年的生存率分别为 5 6.6% ,3 0 .2 % ,14 .4%和 2 .1%。结论 巨大肝癌仍以手术切除为主 ,疗效满意。结合TACE、门静脉取栓和DDS能提高患者的远期生存率。

Objective To investigate the effect of surgical treatment for giant primary liver cancer.Methods One hundred and forty-six cases of giant primary liver cancer received surgical treatment in recent 11 years ware analyzed retrospectively. Of them, 99 cases underwent irregular hepatectomy ,28 hemihepatectomy and 4 right hepatic trisegmentectomy .Including 19 cases received secondary resection after preoperative TACE, meanwhile 6 cases were underwent portal venous cancer thrombus extraction, 15 cases received biopsies and DDS only, Interoprative DDS were performed in 105 cases. Result The postoperative complications was 10.3 %, the postoperative mortality was 1.4%.The 1-,3-,5- and 10year survival rates were 56.6 %, 30.2% ,14.4% and 2.1% respectively. Conclusions The main treatment of giant liver cancer is hepatcctomy.Combination with TACE,portal thrombus extraction and DDS can improve the long-term survival.