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肝细胞癌破裂肝切除术后腹腔镜成功切除腹膜转移灶

Successful laparoscopic extirpation of peritoneal dissemination after hepatectomy for ruptured hepatocellular carcinoma.

作者信息

Hai Seikan, Okada Toshihiro, Iimuro Yuji, Hirano Tadamichi, Suzumura Kazuhiro, Fujimoto Jiro

机构信息

Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.

出版信息

Asian J Endosc Surg. 2015 Nov;8(4):465-7. doi: 10.1111/ases.12212.

Abstract

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.

摘要

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。

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