Midorikawa Takemasa, Kikuchi Hiroaki, Ishibashi Kazuyoshi, Saito Mitsuo, Hatakeyama Toshiyuki, Kadokura Shigeki, Matsumoto Tadashi, Miyakawa Kiyoshi, Maezawa Kouji, Uemichi Osamu, Izuno Hisayuki, Aita Kunitoshi, Nemoto Hiroshi, Nagasaki Hideaki, Yagi Hidefumi
Department of Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
Hepatogastroenterology. 2004 Jul-Aug;51(58):1148-50.
A 54-year-old man had received low anterior resection for rectal carcinoma and extended right hepatectomy for a metastatic liver tumor. One year later, imaging studies disclosed a metastatic liver tumor in segment 2 of the liver. The residual left hepatic vein was completely invaded by the tumor from the root of the hepatic vein to the confluence of several branches by intraoperative ultrasonography. To resect partial liver with the involved hepatic vein was deemed impossible. Microwave coagulation therapy was performed on the tumor and the involved hepatic vein, as we had established the safety of microwave irradiation to the main hepatic vein without interference of the hepatic venous flow in an experimental study. The patient remains well 40 months after the surgery without recurrent signs. The hepatic venous flow of the irradiated hepatic vein is maintained well according to serial examination of Doppler ultrasonography.
一名54岁男性因直肠癌接受了低位前切除术，并因肝转移瘤接受了扩大右肝切除术。一年后，影像学检查发现肝脏2段有一个转移性肝肿瘤。术中超声显示，残留的左肝静脉从肝静脉根部到几个分支的汇合处被肿瘤完全侵犯。切除受累肝静脉的部分肝脏被认为是不可能的。由于我们在一项实验研究中确定了微波照射主肝静脉而不干扰肝静脉血流的安全性，因此对肿瘤和受累肝静脉进行了微波凝固治疗。术后40个月患者情况良好，无复发迹象。根据多普勒超声的系列检查，照射肝静脉的肝静脉血流保持良好。
