Yoshida Hiroshi, Onda Masahiko, Tajiri Takashi, Akimaru Koho, Takasaki Hideaki, Mamada Yasuhiro, Taniai Nobuhiko, Nakamura Yoshiharu, Kawano Youichi, Takahashi Tsubasa
First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
Hepatogastroenterology. 2002 Nov-Dec;49(48):1663-5.
Hepatocellular carcinoma rarely disseminates intraperitoneally. When it does, it usually is considered a terminal event. The successful treatment of complications of peritoneal metastases by surgical resection in a patient with hepatocellular carcinoma is reported. A 63-year-old man with hepatocellular carcinoma in the anterior segment underwent transarterial and portal embolization followed by extended radical hepatectomy. Five years and 8 months later, he presented with an ileus that was secondary to multiple peritoneal metastases that were resected to the extent possible. Eight months later, the patient presented with a second episode of ileus and underwent another operation that included bowel resection. However, pelvic tumors that were unresectable also were present. The patient survived for another 9 months before dying with peritoneal carcinomatosis. Although surgical treatment of peritoneal dissemination of hepatocellular carcinoma is not curative, surgery may improve survival and provide a good quality of life in selected cases.
肝细胞癌很少发生腹膜内播散。一旦发生，通常被视为终末期事件。本文报道了1例肝细胞癌患者通过手术切除成功治疗腹膜转移并发症的病例。1例前段肝细胞癌患者，63岁，先行经动脉和门静脉栓塞术，随后接受扩大根治性肝切除术。5年零8个月后，患者出现肠梗阻，系由多处腹膜转移所致，遂尽可能切除转移灶。8个月后，患者再次出现肠梗阻并接受了包括肠切除在内的另一次手术。然而，盆腔仍存在无法切除的肿瘤。患者在出现腹膜癌后又存活了9个月。虽然手术治疗肝细胞癌的腹膜播散无法治愈，但在某些特定病例中，手术可能会提高生存率并改善生活质量。
