手术切除原发性肝癌333例的经验

The Experience of 333 Cases of Resectable PLC

本文报告手术探查肝癌604例,切除333例,其中小肝癌55例。切除率55.1％、手术死亡率2.4％。小肝癌和大肝癌的术后5、10年生存率分别为50.0％与12.4％、33.3％与8.9％。我们的体会是:(1)临时阻断患侧第一肝门血流法是术中控制出血的最佳方法。(2)经右肋缘下切口行右半肝切除术明显优于胸腹联合切口。(3)随着癌热的升高,切除率和生存率均趋下降,当癌热>39℃时,应视为手术禁忌症。(4)复发性肝癌的最有效疗法是再切除术(5)小肝癌的外科治疗是治愈肝癌的关键。

Of 604 cases of primary liver cancer(PLC),333 were resected and,of the latter,55 cases had small tumor.The overall resectability rate was 55.1%.The operative mortality rate was 2.4%.The 5-and 10-year postoperative survival rates of the small and large PLC were 50.0% vs 12.4%,and 33.3% vs 8.9% respectively.The authors suggest that 1.The best way of controlling bleeding during operation is to block blood flow to the diseased side at the hilum.2.The incision along the right costal margin is better than the abdomino-thoracic incision for right hemihepatectomy.3.The resection rate and survival rate decline when patient had fever.Operation is contraindicated when temperature is above 39℃.4.Secondary excision of recurrent PLC is advisable.5.Surgical treatment of small PLC is crucial to cure PLC.