ALPPS治疗巨大原发性肝癌患者近远期疗效研究

目的 探讨联合肝脏分隔和门静脉结扎的二步肝切除术(ALPPS)治疗巨大原发性肝癌(PLC)患者的近远期疗效.方法 2016年1月～2018年2月我院诊治的98例巨大PLC患者,其中20例接受ALPPS治疗(A组),38例在经肝动脉化疗栓塞术(TACE)治疗后手术切除肿瘤(B组),和40例接受直接手术切除肿瘤(C组).术...

Short-term and long-termsurvivals of patients with huge primary liver cancer after associated liver partition and portal vein ligation for staged hepatectomy

Objective The purpose of this study was to explore the short-term and long-term survivals of patients with huge primary liver cancer(PLC)after associated liver partition and portal vein ligation for staged hepatectomy(ALPPS).Methods The clinical data of 98 patients with PLC including in our hospital between January 2016 and February 2018 were retrospectively analyzed,and 20 patients were treated with ALPPS(group A),38 patients underwent surgical resection after transcatheter hepatic arterial chemoembolization(TACE)(group B),and 40 patients received direct resection of huge liver cancer(group C).The liver regeneration was estimated by post-operational CT scan,and the total liver volume(TLV),the remnant liver volume(RLV)and future remnant liver volume at three months(FRLV)were calculated,and the regenerative volume(RV)and the regeneration rate(RR)were obtained.Results At 3 months after surgery,the FRLV in group A was(366.3±31.7)mL,significantly greater than(185.2±16.4)mL in group B or(181.9±14.2)mL in group C(P<0.05),and the RR was(68.8±6.4)%,significantly higher than(21.4±2.0)%in group B or(22.6±2.3)%in group C(P<0.05);fifteen days after operation,serum albumin level in group A was(37.0±2.7)g/L,significantly higher than(34.1±2.9)g/L in group B or(34.0±3.2)g/L in group C(P<0.05);the two-year total survival and the progress-free survival in group A were 70.0%and 55.0%,and they were 55.3%and 36.8%in group B and 52.5%and 42.5%in group C,not significantly different among them(P>0.05).Conclusion The surgery of ALPPS could rapidly increase the remnant liver volume in a short time after operation,and accelerate the postoperative liver function recovery in patients with PLC,which warrants further investigation.