原发性肝癌术后种植性播散的诊治

目的：研究原发性肝癌术后种植灶的治疗。方法：13例原发性肝癌术后出现种植灶的患者中，单纯腹壁种植2例、单纯腹腔种植9例，腹壁和腹腔同时种植2例。1例腹壁和腹腔均有种植的患者因合并肝内广泛播散和双肺广泛转移而行保守治疗，12例行手术治疗，其中3例因肿块累及肠管而行种植灶和部分肠管切除，其余9例均行单纯种植灶切除，2例患者因腹腔和（或）腹壁种植而行再次种植灶切除。结果：12例获得随访。从种植灶手术时算起，6例均健在，其中生存108个月、57个月、24个月和15个月者各1例。5例分别于6个月（死于再次种植灶切除术后感染性休克）、10个月、14个月、21个月和23个月死亡，保守治疗的1例患者于初次手术后5个月死亡。结论：手术治疗为原发性肝癌术后种植的一种有益的治疗手段。

Diagnosis and Treatment for the Implantation Spreading after Resection of Primary Hepatic Cancer

objective: To study the treatment for the implantation spreading after resection of primary liver cancer. Methods: Among the 13 cases, implantation spreading to abdomen wall, peritoneal cavity, both abdomen wall and peritoneal cavity were found in 2, 9 and 2 patients, respectively. One patient, who had spreading to both abdomen wall and peritoneal cavity had wide metastasis in liver and both lung, received conservative treatment. Other 12 patients received resection. 2 patients received second look resection for reimplantation. Results: 6 patients are still alive except 5 patients died 6, 10, 14, 21, 23 months after resection for spreading, and 1 patient lost follow up. Four patients has been survived for 108, 57, 24 and 15 months, respectively. The patient who received conservative treatment died 5 months after liver resection. Conclusions: Resection is an acceptable treatment for implantation spreading after resection of primary liver cancer.