From 1964 to 1991 , hepatectomy had been done in 166 cases of huge primary liver cancer (PLC) in our hospital.The tumor located in` the left lobe of the liver in 75 cases, right lobe in 75 cases and in the both lobes ...From 1964 to 1991 , hepatectomy had been done in 166 cases of huge primary liver cancer (PLC) in our hospital.The tumor located in` the left lobe of the liver in 75 cases, right lobe in 75 cases and in the both lobes in 16 cases. The tumor size of these patients was 10 cm to 14. 9 cm in diameter in 109 cases, 15 cm to 20 cm in diameter in 45 cases, larger than 20 cm in 12 cases. The largest one was 28 cm × 26 cm. Hepatocellular carcinoma was verified in 93. 4% of these cases. Of them, 125 cases (75 3%) were associated with hepatic cirrhosis. Regular hepatectomy was done in 10 cases; irregular hepatectomy in 156 cases. The following techniques for the interruption of hepatic blood flow were used : continuous mattress suture, hepatic clamp ,temporary occlusion of the hepatic hilum, and microwave coagulation of liver parenchyma. In this series, 95 cases underwent radical resection and 71 cases palliative resection.The postoperative complications were jaundice and ascites in 18 cases, wound infection in 7 cases and right pleural effusion in 7 cases. Three cases died within 1 month after hepatectomy with an operative mortality of 1. 8%. The duration of follow up over 5 yearo was in 64 cases. The 5year survival rate was 17. 5%. All cases who underwent palliative resection died from 2 to 36 months after hepatectomy with an average survival time of 7 months.The biological features of huge PLC and the approaches to improve the prognosis were discussed.展开更多
文摘From 1964 to 1991 , hepatectomy had been done in 166 cases of huge primary liver cancer (PLC) in our hospital.The tumor located in` the left lobe of the liver in 75 cases, right lobe in 75 cases and in the both lobes in 16 cases. The tumor size of these patients was 10 cm to 14. 9 cm in diameter in 109 cases, 15 cm to 20 cm in diameter in 45 cases, larger than 20 cm in 12 cases. The largest one was 28 cm × 26 cm. Hepatocellular carcinoma was verified in 93. 4% of these cases. Of them, 125 cases (75 3%) were associated with hepatic cirrhosis. Regular hepatectomy was done in 10 cases; irregular hepatectomy in 156 cases. The following techniques for the interruption of hepatic blood flow were used : continuous mattress suture, hepatic clamp ,temporary occlusion of the hepatic hilum, and microwave coagulation of liver parenchyma. In this series, 95 cases underwent radical resection and 71 cases palliative resection.The postoperative complications were jaundice and ascites in 18 cases, wound infection in 7 cases and right pleural effusion in 7 cases. Three cases died within 1 month after hepatectomy with an operative mortality of 1. 8%. The duration of follow up over 5 yearo was in 64 cases. The 5year survival rate was 17. 5%. All cases who underwent palliative resection died from 2 to 36 months after hepatectomy with an average survival time of 7 months.The biological features of huge PLC and the approaches to improve the prognosis were discussed.
