巨大肝癌手术切除治疗的临床疗效

目的：通过手术切除巨大肝癌36例，总结手术经验，分析手术疗效和肿瘤复发相关因素。方法：肝门血流阻断16例，半肝血流阻断20例（右半肝阻断14例、左半肝阻断6例）。结果①无手术死亡者；②肝癌复发率为69．44％；③1、2、3年生存率分别为83．33％、44．44％、33．33％。结论巨大肝癌若肿瘤边缘清楚而且患者肝功能正常仍应积极手术切除治疗，半乳治疗，半肝阻断法提高了巨大肝癌的切除率和手术安全性，长了中晚期患者的生存时间，术后经化疗泵化对防治肝癌复发有积极作用。

Clinical Therapeutic Effect of Hepatectomy for Huge Primary Liver Cancer

Objective In order to present clinical experience of resection for primary liver cancer.Methods From July 1995 to July 1999,36 cases of huge primary liver cancer received hepatectomy.16 cases underwent hepatic hilum occlusion and the others half hepatic hilum occlusion.Complications,mortality,recurrence and the survival time were observed.Results No one died from operation.Recurrence rate was 69.44%.1,2,3 year survival rate was 83.33%,44.44%,33.33% respectively.Conclusion Hepatectomy should be performed for the patients with huge primary liver cancer whose liver function is normal and the tumors margins clear.Half hepatic hilum occlusion prolongs vascular occlusion time,improves operative safety.Chemotherapy via the portal vein DDS might prevent the postoperative recurrence and prolongs survival time.