Wang Chuan, Li Chuan, Wen Tian-Fu, Yan Lv-Nan, Li Bo, Liang Guan-Lin, Li Ke-Wei
Sichuan University, Chengdu, China.
Hepatogastroenterology. 2012 Mar-Apr;59(114):526-8. doi: 10.5754/hge11260.
BACKGROUND/AIMS: To assess the surgical safety of synchronous hepatic resection and splenectomy for patients with hepatocellular carcinoma (HCC) and hypersplenism.
Patients with HCC and hypersplenism who underwent surgical treatment were included in this study. According to the difference of operations, patients were divided into two groups (group A, patients who underwent hepatic resection; group B, patients who underwent synchronous hepatic resection and hypersplenism). Pre- and intra-operative parameters were statistically analyzed. Postoperative outcomes including white blood cell and platelet count changes, surgical complications and long-term survival rates were compared.
The pre- and intra-operative parameters of two groups were comparable except for preoperative white blood cell and platelet counts. The incidences of postoperative surgical complication were 53.33% for group A and 35.48% for group B (p=0.161). The 1- and 3-year survival rates of the two groups were 83%, 42% and 82%, 54%, respectively (p=0.313).
Synchronous hepatic resection and splenectomy could increase the postoperative WBC and platelet level for patients with hepatocellular carcinoma and hypersplenism without increasing surgical risks.
背景/目的：评估肝细胞癌（HCC）合并脾功能亢进患者同期肝切除和脾切除的手术安全性。
本研究纳入接受手术治疗的HCC合并脾功能亢进患者。根据手术方式的不同，将患者分为两组（A组，接受肝切除的患者；B组，接受同期肝切除和脾切除的患者）。对术前和术中参数进行统计学分析。比较术后结果，包括白细胞和血小板计数变化、手术并发症及长期生存率。
除术前白细胞和血小板计数外，两组术前和术中参数具有可比性。A组术后手术并发症发生率为53.33%，B组为35.48%（p = 0.161）。两组的1年和3年生存率分别为83%、42%和82%、54%（p = 0.313）。
同期肝切除和脾切除可提高HCC合并脾功能亢进患者术后白细胞和血小板水平，且不增加手术风险。
