中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2014年
6期
405-408
,共4页
余达成%商昌珍%向青锋%曹君%李闻达%张磊%陈亚进
餘達成%商昌珍%嚮青鋒%曹君%李聞達%張磊%陳亞進
여체성%상창진%향청봉%조군%리문체%장뢰%진아진
癌,肝细胞%肿瘤复发,局部%腹腔镜检查%肝切除术
癌,肝細胞%腫瘤複髮,跼部%腹腔鏡檢查%肝切除術
암,간세포%종류복발,국부%복강경검사%간절제술
Carcinoma,hepatocellular%Neoplasm recurrence,local%Laparoscopy%Hepatectomy
目的 评估腹腔镜肝切除治疗开腹手术切除后复发性肝细胞癌的安全性和有效性.方法 回顾性分析2003年1月至201 1年1月14例接受腹腔镜再次肝切除的复发性肝细胞癌患者的临床资料.其中男性9例,女性5例;年龄32 ~ 70岁,平均年龄54岁.在施行腹腔镜再次肝切除前,14例患者均因原发性肝细胞癌接受过至少一次开腹肝切除术.结果 14例腹腔镜再次肝切除手术均顺利完成,其中大块肝切除6例(切除肿瘤最大径≥3 cm),小块肝切除8例(切除肿瘤最大径<3 cm),无严重围手术期并发症.平均手术时间(124±82) min,平均术中出血量(112±43) ml,平均术后住院时间(7±4)d.随访14~42个月,平均随访时间23个月,截至末次随访,11例患者存活(无瘤生存8例,带瘤生存3例).1例患者术后21个月死于肝功能不全,2例患者分别于术后17、31个月死于肿瘤复发.结论 腹腔镜肝切除治疗开腹肝细胞癌切除术后复发性肝细胞癌是可行、安全和有效的,但病例选择标准应从严把握.
目的 評估腹腔鏡肝切除治療開腹手術切除後複髮性肝細胞癌的安全性和有效性.方法 迴顧性分析2003年1月至201 1年1月14例接受腹腔鏡再次肝切除的複髮性肝細胞癌患者的臨床資料.其中男性9例,女性5例;年齡32 ~ 70歲,平均年齡54歲.在施行腹腔鏡再次肝切除前,14例患者均因原髮性肝細胞癌接受過至少一次開腹肝切除術.結果 14例腹腔鏡再次肝切除手術均順利完成,其中大塊肝切除6例(切除腫瘤最大徑≥3 cm),小塊肝切除8例(切除腫瘤最大徑<3 cm),無嚴重圍手術期併髮癥.平均手術時間(124±82) min,平均術中齣血量(112±43) ml,平均術後住院時間(7±4)d.隨訪14~42箇月,平均隨訪時間23箇月,截至末次隨訪,11例患者存活(無瘤生存8例,帶瘤生存3例).1例患者術後21箇月死于肝功能不全,2例患者分彆于術後17、31箇月死于腫瘤複髮.結論 腹腔鏡肝切除治療開腹肝細胞癌切除術後複髮性肝細胞癌是可行、安全和有效的,但病例選擇標準應從嚴把握.
목적 평고복강경간절제치료개복수술절제후복발성간세포암적안전성화유효성.방법 회고성분석2003년1월지201 1년1월14례접수복강경재차간절제적복발성간세포암환자적림상자료.기중남성9례,녀성5례;년령32 ~ 70세,평균년령54세.재시행복강경재차간절제전,14례환자균인원발성간세포암접수과지소일차개복간절제술.결과 14례복강경재차간절제수술균순리완성,기중대괴간절제6례(절제종류최대경≥3 cm),소괴간절제8례(절제종류최대경<3 cm),무엄중위수술기병발증.평균수술시간(124±82) min,평균술중출혈량(112±43) ml,평균술후주원시간(7±4)d.수방14~42개월,평균수방시간23개월,절지말차수방,11례환자존활(무류생존8례,대류생존3례).1례환자술후21개월사우간공능불전,2례환자분별우술후17、31개월사우종류복발.결론 복강경간절제치료개복간세포암절제술후복발성간세포암시가행、안전화유효적,단병례선택표준응종엄파악.
Objective To evaluate the feasibility,safety and long-term outcomes of laparoscopic repeat hepatectomy for recurrent hepatocellular carcinoma (HCC) following previous resection.Methods Between January 2003 and January 2011,14 patients with recurrent HCC were carefully selected to undergo repeat laparoscopic hepatectomy,among which 9 patients were male,5 patients were female,and the average age was 54 years.Prior to re-resection,all patients had undergone at least one open hepatectomy for HCC.The perioperative and long-term outcomes of these patients were retrospectively analyzed.Results Repeat laparoscopic hepatectomy for these 14 patients were successfully performed without major perioperative complications.The mean operative time,introperative blood loss and hospital stay were (124 ± 82) minutes,(112 ±43) ml and (7 ±4) days,respectively.The mean follow-up period was 23 months (range 14 to 42 months).At the time of follow-up,11 patients were still alive,among which 3 patients developed recurrent disease and 8 patients remained disease free.One patient died of liver dysfunction at 21 months,and another 2 patients died of tumor recurrence at 17,31 months,respectively.Conclusion Laparoscopic surgery for recurrent HCC remains a viable option for repeat hepatectomy in selected patients who have undergone open hepatectomy.