Chinburen Jigjidsuren, Gillet Michele, Yamamoto Masakazu, Enkh-Amgalan Tsiiregzen, Taivanbaatar Erdenebileg, Enkhbold Chinbold, Natsagnyam Puntsagdulam
1 HPB Surgery Department, National Cancer Center, Ulaanbaatar, Mongolia.
Int Surg. 2015 Feb;100(2):268-74. doi: 10.9738/INTSURG-D-14-00006.1.
Approaches to surgical resection of centrally located HCC remain controversial. Traditionally, hemi- or extended hepatectomy is suggested. However, it carries a high risk of postoperative complications in patients with cirrhosis. An alternative approach is Glissonean pedicle transection method. This study was conducted to assess the surgical and survival outcomes associated with central liver resection using the Glissonean pedicle transection. Sixty-nine patients with centrally located HCC were studied retrospectively. They were divided into conventional approach group with hemi- or extended hepatectomy, and Glissonean approach group with multisegmental central liver resection using the Glissonean pedicle transection. Glissonean pedicle transection method has comparable or superior surgical and survival outcomes to conventional hemi- or extended hepatectomy with regard to intraoperative bleeding, complications, hospital stay, and postoperative mortality and survival outcomes in patients with centrally located HCC. The 1-, 3-, and 5-year overall survival rates of the conventional approach group were 74%, 64%, and 55% respectively. For the Glissonean approach group, the 1 and 3-year overall survival rates were 86% and 61%, respectively. Glissonean pedicle transection method is a safe and effective surgical procedure in patients with centrally located HCC.
中央型肝癌的手术切除方法仍存在争议。传统上,建议进行半肝或扩大肝切除术。然而,这对肝硬化患者来说术后并发症风险很高。一种替代方法是肝蒂横断法。本研究旨在评估采用肝蒂横断法进行中央肝切除的手术及生存结局。对69例中央型肝癌患者进行了回顾性研究。他们被分为采用半肝或扩大肝切除术的传统方法组,以及采用肝蒂横断法进行多节段中央肝切除的肝蒂法组。在术中出血、并发症、住院时间以及中央型肝癌患者的术后死亡率和生存结局方面,肝蒂横断法与传统的半肝或扩大肝切除术相比,具有相当或更好的手术及生存结局。传统方法组的1年、3年和5年总生存率分别为74%、64%和55%。肝蒂法组的1年和3年总生存率分别为86%和61%。肝蒂横断法对中央型肝癌患者是一种安全有效的手术方法。