Sasaki Y, Imaoka S, Shibata T, Wada H, Nagano H, Kameyama M, Ohigashi H, Hiratsuka M, Ishikawa O, Kabuto T
Dept. of Surgery, Center for Adult Diseases, Osaka.
Gan To Kagaku Ryoho. 1989 Aug;16(8 Pt 2):3045-8.
Different kinds of adjuvant surgery were carried out in three patients with advanced hepatocellular carcinoma (HCC) to enhance the therapeutic effects of chemo-embolization (TAE). The first patient, who had multiple foci localized in the right lobe, underwent ligation of the right portal vein in order to eliminate the small intrahepatic spreads and to protect against transportal metastasis to the left lobe. Afterward, TAEs were repeated a total of 5 times. The patient is still alive 24 months after the surgery with partial remission of the lesions. The second patient with severe cirrhosis had received TAE twice. Since one of the tumors, which existed in the hepatic hilus, did not respond to TAE, only the non-respondent tumor was removed surgically. This patient remains alive 28 months after the surgery with complete remission of the lesions. In the third patient, repeated TAEs resulted in collateral feeding arteries. Permanent decollateralization using silicone rubber sheeting was carried out following ligation of collaterals. Thus adjuvant surgery to enhance the therapeutic effects of TAE may be a significant palliative treatment for HCC.
对3例晚期肝细胞癌（HCC）患者实施了不同类型的辅助手术，以提高化疗栓塞（TAE）的治疗效果。首例患者右叶有多个病灶，接受了右门静脉结扎术，以消除肝内小转移灶，并防止肿瘤经门静脉转移至左叶。此后，共重复进行了5次TAE。术后24个月，该患者仍存活，病灶部分缓解。第二例严重肝硬化患者接受了2次TAE。由于肝门区存在的1个肿瘤对TAE无反应，仅对该无反应肿瘤进行了手术切除。术后28个月，该患者仍存活，病灶完全缓解。第三例患者，重复TAE导致侧支供血动脉形成。在结扎侧支血管后，使用硅橡胶片进行永久性去侧支循环。因此，增强TAE治疗效果的辅助手术可能是HCC一种重要的姑息治疗方法。
