中肝叶巨大肝肿瘤的手术切除

目的探讨中肝叶巨大肝肿瘤切除的安全性和可行性。方法对平均直径13．8cm的37例巨大中肝叶肿瘤，其中包括原发性肝细胞癌18例、胆管细胞癌3例、肝囊腺癌2例、肝海绵状血管瘤13例、肝局灶性结节增生1例，采用入肝血流阻断方法进行肝肿瘤切除。行中肝叶肿瘤切除30例（81．1％），规则性肝切除7例（18．9％）。结果37例巨大中肝叶肿瘤均得以顺利切除，术后无严重并发症发生，肝门阻断时间平均22.6min，出血量平均672ml。结论中肝叶巨大肿瘤切除手术难度大，但只要方法得当，围手术期处理适宜，仍是安全可行的。

Resection for huge liver neoplasms in the middle lobe of liver

Objective To evaluate the safety and feasibility of hepatic resection for huge liver neoplasms in the middle lobe of liver.Methods Thirty-seven cases of huge neoplasms in the middle lobe of liver (18 patients with primary hepatic cellular carcinoma, 3 patients with bile duct cellular carcinoma, 2 patients with hepatic cystadenocarcinoma, 13 patients with hepatic cavernous hemangioma, 1 patients with hepatic focal nodular hyperplasia), with a mean diameter of 13.8 cm, were resected. The hepatectomies were performed under blockade of hepatic inflow, intact tumor resection was performed in 30 patients, and regular hepatic lobectomy was performed in 7 patients.Results All 37 cases were successfully resected. No serious complications occurred, the mean time of blockade of hepatic inflow was 22.6 min, the mean blood loss was 672 ml.Conclusion Although hepatic resection for huge liver neoplasms in the middle lobe of liver is quite difficult, but if suitable surgical techique and perioperative management were adopted, it is safe and feasible.