Lygidakis N J, Vlachos L, Raptis S, Rassidakis G, Balaskas C, Sgourakis G, Mourikis D, Kehagias D, Kittas C
Athens Medical Center, Apollonio Hospital, Greece.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2216-28.
BACKGROUND/AIMS: To assess the value and the safety of main portal branch transection combined with transarterial targeting locoregional neo and adjuvant immunochemotherapy, 32 patients suffering from advanced metastatic liver disease underwent two-stage hepatectomy.
From September 1995 to June 1999, 32 consecutive patients underwent two-stage surgery for advanced metastatic liver disease. Firstly we performed ligation and transection of the main portal branch corresponding to the liver lobe occupied by the tumor and introduction of an arterial jet port catheter towards the hepatic artery. After a locoregional transarterial targeting immunochemotherapy regimen the patient had a 2nd laparotomy for hemihepatectomy. Following surgery, locoregional targeting immunochemotherapy was carried out in all patients via the arterial port of the gastroduodenal artery as an adjuvant treatment.
There were no operative deaths. Mean survival was 27 +/- 8 months.
Two-stage liver surgery is an appealing alternative that increases the resectability rate and overall survival in patients with advanced metastatic liver disease and is associated with excellent quality of post-operative life.
背景/目的：为评估肝门主要分支离断联合经动脉靶向局部新辅助和辅助免疫化疗的价值及安全性，对32例晚期转移性肝病患者实施了两阶段肝切除术。
1995年9月至1999年6月，32例晚期转移性肝病患者连续接受了两阶段手术。首先，我们对肿瘤所在肝叶对应的肝门主要分支进行结扎和离断，并向肝动脉置入动脉喷射端口导管。在进行局部经动脉靶向免疫化疗方案后，患者接受第二次剖腹手术进行半肝切除术。术后，所有患者通过胃十二指肠动脉的动脉端口进行局部靶向免疫化疗作为辅助治疗。
无手术死亡病例。平均生存期为27±8个月。
两阶段肝手术是一种有吸引力的替代方法，可提高晚期转移性肝病患者的切除率和总生存率，且术后生活质量良好。
