术中超声检查在伴有肝硬化的小肝细胞癌切除术中的应用

Intraoperative ultrasonography in resection of small hepatocellular carcinoma associated with cirrhosis.

作者信息

Nagasue N, Kohno H, Chang Y C, Galizia G, Hayashi T, Yukaya H, Nakamura T

机构信息

Second Department of Surgery, Shimane Medical University, Izumo, Japan.

出版信息

Am J Surg. 1989 Jul;158(1):40-2. doi: 10.1016/0002-9610(89)90313-9.

DOI:10.1016/0002-9610(89)90313-9

PMID:2545101

Abstract

Preoperative detectability rates of hepatocellular carcinoma smaller than 5 cm in 113 cirrhotic patients were 91 percent by ultrasonography, 93 percent by computed tomography, and 92 percent by selective angiography. The combination of two methods produced detectability rates of 97 to 99 percent. One hundred three patients underwent various types of hepatic resection with the aid of intraoperative ultrasonography. Forty-four tumors (43 percent) were embedded in the liver, and these tumors were not detected by conventional surgical exploration. The detectability rates were 38 percent for hepatocellular carcinomas smaller than 2 cm, 57 percent for 2 to 3.5 cm tumors, and 71 percent for 3.5 to 5 cm tumors. All undetectable hepatocellular carcinomas were identified by intraoperative echography. The overall detection rate by this method was 98 percent, which was substantially higher than the preoperative rate. Intraoperative ultrasonography is a useful and indispensable method for performing atypical minor hepatectomy for the treatment of small hepatocellular carcinomas associated with liver cirrhosis.

摘要

113例肝硬化患者中，直径小于5 cm的肝细胞癌术前超声检查的可检测率为91%，计算机断层扫描为93%，选择性血管造影为92%。两种方法联合使用时，可检测率为97%至99%。103例患者在术中超声检查的辅助下接受了各种类型的肝切除术。44个肿瘤（43%）位于肝脏内部，这些肿瘤通过传统的手术探查未被发现。直径小于2 cm的肝细胞癌可检测率为38%，2至3.5 cm的肿瘤为57%，3.5至5 cm的肿瘤为71%。所有未被检测到的肝细胞癌均通过术中超声检查得以识别。该方法的总体检测率为98%，显著高于术前检测率。术中超声检查是对与肝硬化相关的小肝细胞癌进行非典型小肝切除术的一种有用且不可或缺的方法。