Dagradi A D, Mangiante G L, Marchiori L A, Nicoli N M
Int Surg. 1987 Apr-Jun;72(2):87-92.
Sixteen patients underwent repeated hepatic resections over a 16 year period. The cases were divided into two groups: group A, non-planned repeated resections (14 cases), and group B, planned repeated resections (two cases). Group A is composed of patients requiring re-resection as a result of the hepatic re-recurrence of the neoplasia (three hepatocellular carcinomas, nine metastases from colorectal carcinoma, and two metastases from carcinoid tumor). Group B is composed of two cases (hepatocellular carcinoma and metastases of leiomyosarcoma) where the extent of the disease was incompatible with radical resection in a single time thus making necessary to plan for repeated operations. The need for correct preoperative assessment of hepatic performance using CT, US and Tc 99m HIDA scan, as well as intraoperative ultrasonography is stressed.
16例患者在16年期间接受了多次肝切除术。这些病例分为两组:A组,非计划性重复切除术(14例),B组,计划性重复切除术(2例)。A组由因肿瘤肝复发而需要再次切除的患者组成(3例肝细胞癌,9例结直肠癌转移,2例类癌转移)。B组由2例(肝细胞癌和平滑肌肉瘤转移)组成,其中疾病范围一次无法进行根治性切除,因此有必要计划进行重复手术。强调了术前使用CT、超声和99m锝-二乙基乙酰苯胺亚氨基二醋酸扫描正确评估肝功能的必要性,以及术中超声检查的必要性。