不能切除肝癌的二期切除（附22例报告）

目的：探讨不能切除肝癌二期切除的必要性及手术指征和手术方式。方法：自1990年至2000年收治不参切除肝癌229例，经各种综合预治疗后有22例获二期切除，其中行肝左叶切除3例，不规上叶切除12例，肝右后叶切除＋门脉癌栓清除4例，肝右后叶切除＋部分膈肌切 中下肺切除1例，肝右叶切除＋部分膈肌切除2例，二期切除距末次治疗时间20天－4个月，中位时间2．3个月。结果：22例二期切除标本均残瘤细胞，术后近期死亡例，1、3、5年生存率为72．73％、45．45％、18．18％，结论不能切除肝的二期切除是提高中晚肝癌切除率，延长生存期的有效途径。

Second stage resection for the unresetabale primary liver cancer : A report of 22 cases

Objective: To evaluate the nesessity ,surgical indication and the way of operation for the unresectable primary liver cancer.Methods:229 cases of unresectable primary liver cancer had been treated in our hospital since 1990 to 2000.After single or combination pre-treatment, 22 cases were secondly resected.The way of the operations were:left hepatic lobectomy in 3 cases, irregular hepatic lobectomy in 12 cases, right posterior lobectomy with embolectomy of the thrombosis in the portal vein 4 cases,right posterior hepatic lobectomy with partial resection of the diaphragm and lobectomy of the right lower lung in one case, right posterior hepatic lobectomy with partial resection of the diaphragm in 2 cases.The time from the final tretment to the second resection was 20 days to 4 months and the mean time was 2.3 months.Results:All the pathologic specimen of the second stage resection in the group were remained caner cell.There was one mortality in a short-term post-operation and the survival rate of 1,3 and 5 years was 72.73%,45.45% and 18.18% ,respectiuely. Conclusion:The second stage resection for the unresectable primary liver cancer is an effective way to improve the long-term survival rate and resection rate for the aduanced cancer.