肝细胞癌肝动脉栓塞化疗降期治疗后根治性切除

摘要

Objective To evaluate the feasibility of radical liver resection following downstaging of hepatocellular carcinoma (HCC) by transcatheter arterial chemoembolization (TACE). Methods Eleven patients with HCC underwent radical liver resection after downstaging of HCC by TACE from January 1991 to June 2002, then the clinical features, intraoperative blood loss, postoperative complications and survival time were studied. Results All patients received the radical liver resection successfully, and the mean intraoperative blood loss and operative time of all the patients Was 1336.4ml (110-3200ml) and 272.8 minutes (210-390 minutes), respectively. Each of the 6 patients had an amount of blood loss more than 1000ml. The postoperative complications included bile leakage (3 patients) and ascites (1 patient), with total incidence of 36%. The median survival time was 61.5 months, and the number of patients survived for 1, 2, 3 years was 8, 7, 6, respectively. Conclusion Radical liver resection after downstaging of HCC by TACE is safe and feasible.%目的 探讨肝细胞癌(hepatocellular carcinoma, HCC)经TACE降期治疗后,实施根治性切除的可行性.方法 回顾性分析1991年1月至2002年6月首次诊断为根治性切除困难的HCC,经TACE降期治疗后,成功实施根治性切除患者的临床特点、手术出血量、术后并发症和生存时间.结果 11例HCC患者经TACE治疗后得到降期,成功实施根治性切除.术中平均出血量1336.4ml(110～3200ml),出血量>1000ml者6例.平均手术时间272.8min(210-390min).术后发生胆漏3例,大量腹水1例.中位生存时间为61.5个月,1、2、3年分别有8、7、6例生存.结论 经TACE治疗HCC,可使部分肿瘤降期后再实施根治性切除,其方法安全可行.