肝癌切除术中肝动脉、门静脉留置IDDS对术后复发的防治价值

目的　探讨肝癌切除术后定期经肝血管化疗对术后复发的监测、预防和治疗价值。方法　原发性肝癌 2 1 4例 ,行肝段或肝叶切除术后分为经周围静脉化疗组 86例和经肝血管埋置全埋植式给药装置 (IDDS)化疗组 1 2 8例 ,两组术后定期化疗 ,观察其半年、1年、2年、3年的复发率。结果　IDDS化疗组的 1年、2年、3年复发率分别为 2 4 . 2 2 %、35. 94 %、5 9 .38%,明显低于周围静脉组的 37 .2 0 %、5 5 . 81 %、82 . 5 6 %(P <0 . 0 5 ) ,而且肝动脉、门静脉双插管组的术后复发率明显低于肝动脉插管组和门静脉插管组 (P <0 . 0 5 )。结论　肝癌切除术中肝血管埋置IDDS ,对术后复发的监测、预防和治疗有实用价值 ,肝动脉、门静脉双插管组的疗效明显优于单纯肝动脉插管组或门静脉插管组。

The Effect of Implanting IDDS in Hepatic Artery and Portal Vein during Liver Resection for Primary Iiver Carcinoma

Objective To study the role of implanting IDDS and periodic chemotherapy via hepatic artery and portal vein during liver resection for surveillance,prevention and treatment of the postoperative recurrence of primary liver carcinoma.Methods 214 cases of primary liver carcinoma were performed hepatectomy,128 among them were implanted IDDS,and periodic chemotherapy were done through hepatic artery and portal vein by way of IDDS;the other 86 cases were accepted periodic chemotherapy via peripheral vein after the operation.Observed the half-a-year,1-year,2-year and 3-year recurrence rate.Results The 1-year,2-year and 3-year recurrence rate in the group of IDDS chemotherapy were 24.22%?35.94% and 59.38% respectively,significantly lower than those in the other group by 37.20%,55.81%,82.56%(P<0.05).The recurrence rate of both hepatic artery and portal vein implanted IDDS were lower than that of single hepatic artery or portal vein implanted IDDS.Conclusions Intraoperative hepatic artery and portal vein catheterization has a practical benefit for monitoring,prevention and treatment of the postoperative recurrence of primary liver carcinoma.The effect of both hepatic artery and portal vein implanted IDDS is better than that of single hepatic artery or portal vein implanted IDDS.