摘要
目的 评价一期肝癌切除和门静脉高压症手术的疗效。 方法 回顾性分析１９９３ 年３月至１９９６ 年１２ 月同期进行肝癌切除和门静脉高压症手术３０ 例。 结果 术后１ 、２ 、３ 年绝对生存率分别为２２／２９（７６ ％ ） 、１７／２５（６８ ％ ） 、１０／２２（４６ ％ ） 。其中小肝癌分别为８／９（８９ ％ ） 、８／９（８９ ％ ） 、５／７（７１ ％ ） ；大肝癌和多发性癌分别为１４／２０（７０ ％ ） 、９／１６（５６ ％ ） 、５／１５（３３ ％ ） 。术后发生上消化道出血３例。随访中死亡１２ 例，死亡原因：肝癌复发７ 例，肝功能衰竭４ 例，上消化道大出血１ 例。其中２ 例为手术死亡，手术死亡率７ ％ 。 结论 该手术方便实用，但要注意适应症选择，小肝癌切除联合贲门周围血管离断疗效良好，大肝癌和多发性肝癌宜选用创伤小的术式。
Objective To evaluate the effect of one stage liver resection and collateral devascularization for the treatment of hepatic cancer patients suffering from portal hypertension.Methods Retrospective analysis was made on 30 cases undergoing hepatectomy for the liver cancer and portaazygous devascularization for the portal hypertension in one stage from Mar. 1993 to Dec. 1996.Results The 1,2,3 year′s absolute survival rate was 22/29 (75 9%),17/25 (68%),and 10/22 (45 5%),respectively.The survival rate for small liver cancer was 8/9 (88 9%),8/9 (88 9%),5/7 (71 4%) respectively,and that for large cancer or multiple foci was 14/20 (70 0%),9/16 (56 3%),5/15 (33 3%),respectively.Postoperative varices bleeding occured in 3 cases.12 died during follow up period including cancer recurrence in 7,liver failure in 4,variceal bleeding in 1.Operative mortality was 6 7%.Conclusions For the safety of the patients,in those with small liver cancer hepatectomy could be combined with pericardial devescularization,whereas in those with large cancer or multiple foci,hepatectomy should be combined with less traumatic simple collateral veins ligature.
出处
《中华普通外科杂志》
CSCD
1999年第5期357-358,共2页
Chinese Journal of General Surgery
关键词
肝细胞癌
并发症
外科手术
门脉高压症
Carcinoma,hepatocellular Hypertention,portal Surgery,operative
