原发性肝癌的再切除

目的 总结27例肝癌再次手术切除的经验.方法 1986～2009年笔者所在科行肝癌再次切除的患者27例,其中再切除24例,三次切除3例.经右胸腹联合切口切除2例,同期行右肺转移癌切除.全部病例均采用不规则性的肝叶切除术.术中癌瘤的完整切除,门静脉癌栓的摘除,肝门转移淋巴结的摘除是防止再复发的关键.结果 无手术死亡率,1、3、5年生存率分别是87.5%、44.2%、12.5%.生存10年以上3例.结论 再次的肝癌切除术是首次切除的补充,是原发性肝癌延长生存期,提高生存质量最有效的办法.

Re-resection for recurrent hepatocellular carcinoma

Objective Tn explore the treatment of resection for 27 cases with recunent hepacellular cancer. Methods From 1986 to 2009,the clinieal data,operative method and prognosis from 27 cases with recurrent liver cancer were analyzed retrospectively. Re - hepatectomy was performed on 2 cases, and third - hepatectomy was performed on 3 eases. There were 4 eases peritoneal cavity seeding neoplasm,and 2 cases was operated on right thoracoabdominal approach. All patients underwent nonanatmnieal hepatectomy. Local radical resection, removing portal vein cancer embolus, removing porta hepatis lymph nodes,all the three factor was important to prevent re - recurrence. Results There were no operative death. The 1,3 and 5 - year surival rates after re - resection in the total group were 87.5% ,44.2% and 12.5% respectively. 3 cases lived hmger than 10 years. Conclusion Repeated operation is supplement for the first resection of primary liver cancer , also it is the most effective method of prolonging survival time and improving life quality for recurrent liver cancer.