Hai Seikan, Okada Toshihiro, Iimuro Yuji, Hirano Tadamichi, Suzumura Kazuhiro, Fujimoto Jiro
Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Asian J Endosc Surg. 2015 Nov;8(4):465-7. doi: 10.1111/ases.12212.
Clinically, peritoneal dissemination of hepatocellular carcinoma (HCC) rarely occurs. We herein report a case that had a good outcome following laparoscopic extirpation of peritoneal dissemination after hepatectomy for ruptured HCC. A 66-year-old man underwent central bisectionectomy 12 days after emergency transcatheter arterial embolization for a ruptured HCC. Thereafter, pulmonary resection was performed twice for lung metastasis. About 8 months after the second pulmonary resection, a mass lesion was detected at the left subphrenic space on CT and (18) F-fluorodeoxyglucose PET scans. We made a diagnosis of peritoneal dissemination of HCC, and laparoscopic extirpation was performed. The patient is now doing well without any signs of recurrence 2 years after the last operation. Laparoscopic surgical resection for peritoneal dissemination that develops after hepatectomy for HCC may have a beneficial effect as a less-invasive approach and may improve the prognosis in select patients.
临床上,肝细胞癌(HCC)的腹膜播散很少见。我们在此报告一例在肝切除术后因破裂性HCC行腹腔镜下腹膜播散病灶切除术后预后良好的病例。一名66岁男性在因破裂性HCC行急诊经导管动脉栓塞术后12天接受了肝中叶切除术。此后,因肺转移进行了两次肺切除术。在第二次肺切除术后约8个月,CT和(18)F-氟脱氧葡萄糖PET扫描显示左膈下间隙有一肿块病变。我们诊断为HCC腹膜播散,并进行了腹腔镜切除。患者在最后一次手术后2年情况良好,无任何复发迹象。对于HCC肝切除术后发生的腹膜播散,腹腔镜手术切除作为一种侵入性较小的方法可能具有有益效果,并可能改善部分患者的预后。