巨大肝癌的外科手术治疗

目的探讨巨大肝癌外科治疗的可行性及手术要点。方法回顾性分析2008年7月至2010年5月间外科治疗的17例巨大肝癌手术及预后效果。结果手术切除率100%,围手术期病死率零。规则性切除4例,不规则性切除13例,平均手术时间（106±22）min（85～170 min）,平均术中失血（400±221）ml（100～1100 ml）,术后并发症11人,术后平均住院（15±4）d（11～21 d）,随访4～28个月,存活16例,死亡1例。结论巨大肝癌外科手术切除是可行的。手术的关键是术前做好认真评估和准备、制定切实可行的手术方案,术中避免大出血、保护好残余肝体积及功能,术后及时发现和处置并发症。

Surgical treatment of giant primary liver cancer

Objective To investigate the feasibility and key points of surgical treatment of giant primary liver cancer.Methods Surgical methods and therapeutic effect of 17 cases receiving surgical treatment for giant primary liver cancer in recent 2 years were analyzed retrospectively.Of them,13 cases underwent irregular hepatectomyand 4 cases underwent regular hepatectomy.Results Liver neoplasms of all 17 cases were resected.There was no perioperative death.Average operative time was（106±22） min（85-170 min）,while average blood loss was about（400±221） ml（100-1100 ml）.The mean postoperative complications were seen in11person.16 cases survived and 1case died after 4-28 months follow up study.Conclusion The main treatment of giant liver cancer is hepatectomy.The key points of surgical treatment are preoperative assessment and preparation earnestly,formulate feasible operation program,avoiding intraoperative massive hemorrhage,protecting residual liver function and disposal of postoperative complication timely.