Yamaoka Y, Kumada K, Ino K, Takayasu T, Shimahara Y, Mori K, Tanaka A, Morimoto T, Taki Y, Washida M
Second Department of Surgery, Kyoto University Faculty of Medicine, Japan.
World J Surg. 1992 Nov-Dec;16(6):1172-6; discussion 1177. doi: 10.1007/BF02067093.
Since the tumor thrombus in the main portal vein appears in the terminal stage of hepatocellular carcinoma (HCC), any attempt to remove it surgically is thought to be impractical as the malignancy itself cannot be entirely removed. During the past 5 years, we have performed tumor thrombectomy combined with hepatectomy in 29 of 298 patients with HCC. This combined therapy was initially decided upon as an emergency measure to prevent impending rupture of esophageal varices, rather than to improve patient survival. Since portal flow was obtained after removal of thrombi, this condition enabled transcatheter arterial embolization (TAE) and/or percutaneous ethanol injection therapy (PEIT). Although improved patient survival was not the primary goal of the emergency operation and there was an operative mortality of 11%, half of the other patients in the present series had unexpectedly high survival rates of 1 year (52.2%), 2 years (23.2%), and 3 years (11.6%), which were significantly higher than in patients not undergoing operation (n = 22).
由于主门静脉内的瘤栓出现在肝细胞癌（HCC）的终末期，人们认为任何手术切除瘤栓的尝试都是不切实际的，因为恶性肿瘤本身无法完全切除。在过去5年中，我们在298例HCC患者中的29例中进行了瘤栓切除术联合肝切除术。这种联合治疗最初是作为预防食管静脉曲张即将破裂的紧急措施而决定的，而不是为了提高患者的生存率。由于在去除血栓后获得了门静脉血流，这种情况使得能够进行经导管动脉栓塞术（TAE）和/或经皮乙醇注射治疗（PEIT）。虽然提高患者生存率不是急诊手术的主要目标，且手术死亡率为11%，但本系列中的其他患者中有一半的1年（52.2%）、2年（23.2%）和3年（11.6%）生存率意外地高，显著高于未接受手术的患者（n = 22）。
