中晚期肝癌的外科治疗

目的 对中晚期肝癌外科治疗的有关问题进行探讨，总结手术切除中晚期肝癌62例，其中各类肝叶、肝段切除40例，非规则性肝切除22例，手术并发症发生率为15．0％，死亡率为3．0％。方法 对中晚期肝癌主张行非规则性肝切除，尽可能保存正常肝组织。结果 术中阻断第一肝门52例，全肝血流阻断10例。阻断时间分别为6～28m和4～25min。对中央型肝癌主张行全肝血流阻断，以防止术中大出血和空气栓塞。结论 切肝方法以钳夹法为实用而简便，术后加强护肝治疗。

Surgical treatment of liver cancer in middle and advanced stage

Objective] Based on the surgical treatment of middle and advanced liver cancer, a summary of 62 cases by surgical operation was made, among which there are 40 cases of hepatic segmentectomy and lobectomy, 22 cases of irregular hepatectomy. The postoperative morbidity was 15%, while mortality was 3%. Methods] For middie and advanced liver cancer patients, irregular hepatectomy is a good choice, so the normal liver tissue can be kept as much as one can. Results] Hepatic hilar occlusion was performed in 52 cases with total liver vascular occlusion performed in 10 cases. Occlusion time was 6-28 mins and 4-25 rains respectively. As for central hepatic carcinoma, total liver vascular occlusion is adopted in case the massive haemorrhage and air embolism occur during the operation. Conclusion] The jaw operation in hepatectomy is practical and convenient, but it is important to take good care of liver after surgical treatment.