Wang Fu-Qiang, Lu Qian, Yan Jun, Peng You-Yuan, Xie Cheng-Rong, Su Yong-Jie, Zhou Jian-Yin, Wang Bo-Liang, Zhao Wen-Xiu, Wang Xiao-Min, Bie Ping, Yin Zhen-Yu
Department of Hepatobiliary Surgery, Zhongshan Hospital of Xiamen University, Fujian Provincial Key Laboratory of Chronic Liver Disease and Hepatocellular Carcinoma, Xiamen, Fujian, P.R. China.
Department of Hepatobiliary Surgery, Southwest Hospital, The Third Military Medical University, Chongqing, P.R. China.
Oncol Lett. 2015 May;9(5):2199-2204. doi: 10.3892/ol.2015.3041. Epub 2015 Mar 16.
We previously reported the case of a 56-year-old male who underwent surgical treatment for gastric hepatoid adenocarcinoma and splenic metastasis. The present study reports the case of the same patient who underwent successful hepatectomy and partial liver autotransplantation. Computed tomography scans demonstrated that the tumor was located in the left and caudate lobes of the liver, with hepatic vein and inferior vena cava involvement, and right portal vein compression. To clarify the association between the vessels and the tumor, a three-dimensional imaging technique was used to reconstruct the liver architecture. During the surgery, the whole liver was removed with the retrohepatic vena cava, which was replaced with a prosthetic graft without a veno-venous bypass; a portacaval shunt for the anhepatic phase was performed simultaneously. The surgery lasted 9 h, and the anhepatic phase lasted 4 h. Blood loss during the surgery was recorded at 1,500 ml. The time taken for recovery was 21 days post-surgery, and at 20 months, the patient was disease-free. To the best of our knowledge, this is the first case of liver resection performed for hepatic metastasis of hepatoid adenocarcinoma to be reported.
我们之前报道过一例56岁男性胃肝样腺癌伴脾转移患者接受手术治疗的病例。本研究报告了同一患者成功接受肝切除及部分肝脏自体移植的病例。计算机断层扫描显示肿瘤位于肝脏左叶和尾状叶,累及肝静脉和下腔静脉,并压迫右门静脉。为明确血管与肿瘤之间的关系,采用三维成像技术重建肝脏结构。手术过程中,完整切除肝脏及肝后下腔静脉,在无静脉-静脉转流的情况下用人工血管替代;同时进行无肝期的门腔分流术。手术持续9小时,无肝期持续4小时。术中失血记录为1500毫升。术后恢复时间为21天,术后20个月患者无疾病复发。据我们所知,这是首例报道的因肝样腺癌肝转移而行肝切除的病例。