Futagawa S, Kojima K, Sugiura M
Nihon Geka Gakkai Zasshi. 1985 Sep;86(9):1234-6.
This report describes 53 patients with hepatocellular carcinoma (HCC) complicated with esophageal varices. Esophageal varices were due to cirrhosis of the liver in all cases. Hepatic resection and blocking operations such as Sugiura procedure, transabdominal esophageal transection or Hassab's operation were performed for the treatment of HCC and esophageal varices in 6 cases with satisfactory results. Non-operative treatments such as TAE or arterial infusion chemotherapy for HCC and blocking operations for esophageal varices were performed in 17 cases. Late deaths were recognized in 10 cases. Causes of late deaths were carcinoma of the liver in 7 cases and ruptured varices in only 1 case. In 13 cases with severe hepatic failure, only endoscopic sclerotherapy was performed for the treatment of esophageal varices. However 8 cases of 13 had rebleeding from esophageal varices and died after sclerotherapy. We concluded that effective treatments for HCC complicated with esophageal varices were to perform both the hepatic resection and the blocking operation and these treatments prolong the long-term survival of patients with HCC with esophageal varices.
本报告描述了53例肝细胞癌（HCC）合并食管静脉曲张的患者。所有病例中食管静脉曲张均由肝硬化引起。对6例患者进行了肝切除及诸如杉浦手术、经腹食管横断术或哈萨布手术等阻断手术，以治疗HCC和食管静脉曲张，效果满意。对17例患者进行了非手术治疗，如针对HCC的TAE或动脉灌注化疗以及针对食管静脉曲张的阻断手术。有10例患者出现晚期死亡。晚期死亡原因中，7例为肝癌，仅1例为静脉曲张破裂。在13例严重肝功能衰竭的患者中，仅对食管静脉曲张进行了内镜硬化治疗。然而，13例中有8例在硬化治疗后食管静脉曲张再次出血并死亡。我们得出结论，对于HCC合并食管静脉曲张的有效治疗方法是同时进行肝切除和阻断手术，这些治疗可延长HCC合并食管静脉曲张患者的长期生存期。
