经肝后下腔静脉前间隙入路行巨大肝癌切除:附38例

摘要

目的 探讨巨大肝癌的可切除性及切除方法的改进.方法 回顾性分析2003年5月至2006年12月潍坊市人民医院肝胆外科手术切除的38例巨大肝癌资料.38例巨大肝癌平均直径14.4 cm(10.5～27 cm).术中先行结扎患侧肝动脉及门静脉.解剖打通肝后下腔静脉前间隙,在绕肝带捆扎指示下前入路法逆行切除瘤体.结果 38例手术均取得成功,平均出血量850 ml(300～2700 ml).围手术期无死亡.1、2、3年生存率分别为78.9%、57.9%、39.5%.结论 巨大肝癌非手术禁忌,经肝后下腔静脉前间隙入路行巨大肝癌切除安全可靠.%Objective To investigate the possibility and the changing of the method of surgical excision for large hepatocellutar carcinoma(HCC).Methods The clinical data of 38 cases with large HCC treated in our hospital from May 2003 to December 2006 were retrospectively analyzed.The av-erage diameter of the 38 cases was 14.4 cm(10.5-27 cm).The hepatic artery and portal vein of the trouble side were ligated firstly in the operation and then the retrohepatic tunnel established.We took the method of the former approach to resect tumors retrogradely.Results The operation was success-fully conducted in all the 38 cases and the average amount of bleeding was 850ml(300-2700 ml).No death occurred during hospitalization.The 1-,2-and 3-year survivaI rates were 78.9%,57.9%and 39.5%.respectively.Conclusion It is safe to resect the large HCC through the retrohepatic tunnel.