可切除大肝癌术前TACE对手术的影响

目的探讨术前经导管肝动脉化疗栓塞（TACE）对可切除大肝癌手术的影响。方法将108例大肝癌病例分成术前TACE组（52例）与一期手术组（56例）,术前TACE组经TACE后行手术的为二期手术组（47例）,比较两组肿瘤大小、手术探查情况及手术相关因素和并发症情况。结果术前TACE组经TACE后5例失去手术机会,手术探查见肿瘤周围粘连明显增加,肝硬化加重,手术时间延长;两组肝门阻断时间、术中平均出血量、术后并发症等指标无统计学差异,二期手术组TACE后平均肿瘤直径缩小并不显著。结论大肝癌术前TACE增加手术难度及手术风险,并有可能耽误手术时机,应首选手术治疗。

Influence of preoperative TACE on hepatectomy in patients with resectable large hepatocellular carcinoma

Objective To investigate influence of preoperative transcatheter arterial chemoembolization（TACE） on hepatectomy in patients with respectable large hepatocellular carcinoma（HCC）. Methods One hundred and eight patients with respectable large primary liver cancers were divided into two groups： preoperative TACE group（n=52） and one-stage operation group（n=56）,hepatectomy was performed in 47 out of 52 patients（two-stage operation group）,influence factors of hepatectomy were compared with that of the 56 patients without TACE including preoperative tumor size,operative factors and complications. Results Operative chances were lost in 5 out of 52 patients after TACE in preoperative TACE group.Liver adhesions were more serious in TACE group than in no TACE group,and the operation time was longer in TACE group.There was no statistic difference in the average time of clamping porta hepatis,blood loss and postoperative complications in the two groups.No significant diminution in the average tumor size after TACE in two-stage operation group. Conclusion Preoperative TACE for resectable large HCC damages liver function,increases surgical difficulty and risk,maybe delay operation chance.Surgical treatment should be preferred.