Wolff H, Sperling P
Zentralbl Chir. 1986;111(1):3-15.
An account is given in this paper of surgical treatment of malignant tumors of the liver of patients in the Surgical Department of Charité over the past six years, with reference being made to both indications for surgery and therapeutic results. - In the period under review, treatment was applied to 335 patients with malignant tumors of the liver, among them 168 with liver metastases. Thirty-eight per cent of all tumours treated were localised in the right lobe and 19 per cent in the left. The portal hilum was affected in 15 per cent of all cases and the entire liver in 28 per cent. Promising curative therapy was considered practicable for 67 patients, whereas three underwent palliative surgery. Liver transplantation was performed on 21 patients with malignant tumours not accessible to meaningful surgical approach. The resection rate in cases of liver malignoma was 14.6 per cent. The record included 14 hemihepatectomies on the right side and eleven on the left as well as 24 instances of atypical or segment removal, primarily in cases of liver metastasation. Surgical lethality amounted to 6.1 per cent, while the three-year survival rate was 55 per cent, with the most favourable results being recorded from hepatocellular carcinoma with 81 per cent. Only seven per cent of 265 patients with inoperable malignant liver tumours were left alive after one year. Impaired wound healing, the most common postoperative complication, had to be coped with in 21 per cent of all cases. The rate of complications proved to be substantially controllable by pre-operative conditioning and careful postoperative intensive care.
本文介绍了过去六年中夏里特医院外科对肝癌患者的手术治疗情况,涉及手术适应症和治疗效果。——在审查期间,对335例肝癌患者进行了治疗,其中168例有肝转移。所有接受治疗的肿瘤中,38%位于右叶,19%位于左叶。15%的病例门静脉肝门受影响,28%的病例整个肝脏受影响。认为67例患者可行有前景的根治性治疗,而3例接受了姑息性手术。对21例无法进行有意义手术的恶性肿瘤患者进行了肝移植。肝癌病例的切除率为14.6%。记录包括14例右侧半肝切除术、11例左侧半肝切除术以及24例非典型或节段性切除,主要是在肝转移的病例中。手术死亡率为6.1%,三年生存率为55%,肝细胞癌的结果最理想,为81%。265例无法手术的恶性肝肿瘤患者中,只有7%在一年后仍存活。伤口愈合不良是最常见的术后并发症,所有病例中有21%需要应对。事实证明,通过术前准备和术后精心的重症监护,并发症的发生率在很大程度上是可控的。