CAJ | 학술논문

目的探讨肝脏Ⅸb段肿瘤手术切除的可行性和疗效.方法回顾性分析2003年3月至2007年1月行手术切除的15例Ⅸb段肝肿瘤患者的临床资料.结果 15例患者中13例为原发性肝癌,其余2例为良性肿瘤;肿瘤平均最大径为(4.3±1.6)cm,均经劈开肝脏的前径路切除,其中11例在肝门、全肝血流序贯阻断下完成,其余4例仅作了肝门阻断;全组无手术死亡,平均手术时间为(190.3±37.6)min,平均手术失血量为(376.7±252.7)ml;术后除1例出现腹水、下肢水肿外,其余病例均未发生明显并发症,术后平均住院天数为(13.3±6.0)d;随访结果:2例良性肿瘤患者已恢复正常生活;13例原发性肝癌患者中3例术后肝内复发,其中1例已死亡,其余10例均无瘤生存,中位无瘤生存期为23.5个月.结论手术切除IXb段肝肿瘤安全可行;局部切除对于多数肝癌患者能达到根治目的.
목적 탐토간장Ⅸb단종류수술절제적가행성화료효.방법 회고성분석2003년3월지2007년1월행수술절제적15례Ⅸb단간종류환자적림상자료.결과 15례환자중13례위원발성간암,기여2례위량성종류;종류평균최대경위(4.3±1.6)cm,균경벽개간장적전경로절제,기중11례재간문、전간혈류서관조단하완성,기여4례부작료간문조단;전조무수술사망,평균수술시간위(190.3±37.6)min,평균수술실혈량위(376.7±252.7)ml;술후제1례출현복수、하지수종외,기여병례균미발생명현병발증,술후평균주원천수위(13.3±6.0)d;수방결과:2례량성종류환자이회복정상생활;13례원발성간암환자중3례술후간내복발,기중1례이사망,기여10례균무류생존,중위무류생존기위23.5개월.결론 수술절제IXb단간종류안전가행;국부절제대우다수간암환자능체도근치목적.
Objective To evaluate the feasibility and the effect of surgical resection of hepatic tumor originated from segment Ⅸb.Methods The cases with hepatic tumors in segment Ⅸb who had been operated on between March 2003 and January 2007 were retrospectively reviewed.Results A total of 15 tumors in segment Ⅸb,including 13 primary liver cancers and 2 benign tumors with a mean diameter of(4.3±1.6)cm,were successfully resected by anterior transhepatic approach under sequential occlusions of portal tride and total hepatic vaseularity or portal tride clamping only.There was no operative mortality,with a mean operative time of(190.3±37.6)min and a mean operative blood lose of(376.7±252.7)ml. All the patients had uneventful postoperative course except one who suffered from ascites and edema of the low body,which was successfully managed medically.The mean postoperative hospital stay was(13.3±6.0)d.During the follow-up of 1-47 months,two patients with benign tumor enjoyed a normal life.Among the 13 patients with primary live cancers,1 patient died of recurrence,2 patients remained alive with intrahepatic recurrence and 10 patients survived without any sign of relapse,with a median tumor-free survival time of 23.5 months.Conclusions Surgical resection of hepatic tumor in segment Ⅸ b,despite their sophisticated anatomic position,is feasible in technique with high safety.The local resection can provide the patients with potential to cure.