肝细胞癌自发性破裂：手术切除与长期生存
Spontaneous rupture of hepatocelluar carcinoma: surgical resection and long-term survival.
作者信息
Vergara V, Muratore A, Bouzari H, Polastri R, Ferrero A, Galatola G, Capussotti L
机构信息
First Surgical Department, 'Umberto I' Mauriziano Hospital, Torino, Italy.
出版信息
Eur J Surg Oncol. 2000 Dec;26(8):770-2. doi: 10.1053/ejso.2000.1001.
AIMS
Spontaneous rupture of hepatocellular carcinoma (HCC) is a life-threatening event, particularly in patients with associated cirrhosis. We present our experience of hepatic resection of ruptured HCC.
METHODS
We performed 199 resections of hepatocellular carcinoma between January 1984 and December 1999. Six (3%) of these patients were operated on as an emergency because of haemoperitoneum: in five the liver was cirrhotic.
RESULTS
The mean duration of the operation was 195+/-101 min; all the patients received blood transfusions. The overall morbidity was 50%, with a mortality rate of 16.5%. Three patients were alive at 50, 80 and 116 months respectively; two had an intrahepatic recurrence treated by chemoembolization.
CONCLUSIONS
Non-surgical treatment of spontaneously ruptured hepatocarcinoma should be performed only in patients with contraindication to surgery. Hepatic resection should be the treatment of choice since, according to our experience, long-term results are similar to those of elective surgery.
目的
肝细胞癌（HCC）自发性破裂是一种危及生命的事件，尤其在伴有肝硬化的患者中。我们介绍我们对破裂性HCC进行肝切除的经验。
方法
1984年1月至1999年12月期间，我们对199例肝细胞癌患者进行了切除术。其中6例（3%）因腹腔积血作为急诊手术：5例肝脏为肝硬化。
结果
手术平均时长为195±101分钟；所有患者均接受了输血。总体发病率为50%，死亡率为16.5%。3例患者分别在50、80和116个月时存活；2例肝内复发患者接受了化疗栓塞治疗。
结论
自发性破裂肝癌的非手术治疗仅应在有手术禁忌证的患者中进行。肝切除应作为首选治疗方法，因为根据我们的经验，长期结果与择期手术相似。
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