Rui J, Wang S, Chen S
Liver Cancer Institute, Post and Telecomm General Hospital, Eighth Clinical School, Peking University, Beijing 100032, China.
Zhonghua Wai Ke Za Zhi. 2001 Oct;39(10):759-63.
To evaluate the feasibility and effect of hepatic trisegmentectomy for patients with huge neoplasms of liver.
From July 1993 to October 1999, 29 patients with huge hepatic neoplasms underwent hepatic trisegmentectomy, (23 patients with primary liver cancer, 1 patient with hepatic infiltration of gallbladder cancer, 1 patient with metastasis of colon cancer, 1 patient with hepatic angiosarcoma, 1 patient with hepatic neurofibroma, and 2 patients with huge liver cyst). Of these patients, 26 underwent right trisegmentectomies and the rest 3 accepted left trisegmentectomies. All trisegmentectomies were performed under normothermic interruption of the porta hepatis at single time and these interruptions lasted 15 to 40 minutes.
The relatively good effect was seen in our series of trisegmentectomies. The 1-, 3-, 5-year survival rates for patients with primary liver cancer were 63.6%, 36.4% and 27.3%, respectively. The survival time for patients with hepatic infiltration of gallbladder cancer and metastasis of colon cancer in the liver was 6 months. The patients with hepatic angiosarcoma, hepatic neurofibroma and 2 huge liver cysts survived 35, 26, 25, 40 months and 1 till to the latest follow-up, respectively. Main complications were present in 5 patients. Mortality within 1 month was 3.4% (1/ 29).
Hepatic trisegmentectomy is safe and effective in treatment of huge hepatic neoplasms if its indications and operative techniques are mastered properly.
评估肝三叶切除术治疗巨大肝脏肿瘤患者的可行性及效果。
1993年7月至1999年10月，29例巨大肝脏肿瘤患者接受了肝三叶切除术，其中原发性肝癌23例，胆囊癌肝浸润1例，结肠癌肝转移1例，肝血管肉瘤1例，肝神经纤维瘤1例，巨大肝囊肿2例。这些患者中，26例行右三叶切除术，其余3例行左三叶切除术。所有三叶切除术均在常温下一次性阻断肝门进行，阻断时间为15至40分钟。
我们的三叶切除术系列取得了相对较好的效果。原发性肝癌患者的1年、3年、5年生存率分别为63.6%、36.4%和27.3%。胆囊癌肝浸润和结肠癌肝转移患者的生存时间为6个月。肝血管肉瘤、肝神经纤维瘤患者及2例巨大肝囊肿患者分别存活35个月、26个月、25个月、40个月，1例存活至最近一次随访。5例出现主要并发症。1个月内死亡率为3.4%（1/29）。
如果正确掌握肝三叶切除术的适应证和手术技巧，该手术治疗巨大肝脏肿瘤是安全有效的。
