Kanematsu T, Takenaka K, Matsumata T, Furuta T, Sugimachi K, Inokuchi K
Ann Surg. 1984 Jan;199(1):51-6. doi: 10.1097/00000658-198401000-00009.
We evaluated in retrospect the applicability of limited hepatic resection in cases of primary liver cancer in cirrhotic patients. According to the severity of impaired liver function, 37 patients underwent limited resection, and for 13, standard major hepatic resection was done. The mortality rate in case of limited resection was 10.8%, and the rate in case of massive excision was 15.4%. One, two- and five-year survival rates of limited operation were 79.9, 60.3, and 32.6%, respectively. After standard resection, the rates were 78.7, 67.5, and 22.5%, respectively. There were no significant differences in the mortality and survival rates between the two groups. These results indicate that, for the patient with a small liver cancer, and poor liver function, the limited procedure leads to a comparatively longer survival. This limited resection can be selectively used to treat cancer associated with cirrhosis and encapsulated tumors. For the preoperative evaluation, hepatic arteriograms aid in patient selection.
我们回顾性评估了有限肝切除术在肝硬化患者原发性肝癌病例中的适用性。根据肝功能受损的严重程度,37例患者接受了有限切除术,13例患者进行了标准的大肝切除术。有限切除术的死亡率为10.8%,大规模切除术的死亡率为15.4%。有限手术的1年、2年和5年生存率分别为79.9%、60.3%和32.6%。标准切除术后,这些比率分别为78.7%、67.5%和22.5%。两组之间的死亡率和生存率没有显著差异。这些结果表明,对于患有小肝癌且肝功能较差的患者,有限手术可带来相对较长的生存期。这种有限切除术可选择性地用于治疗与肝硬化相关的癌症和包膜肿瘤。对于术前评估,肝动脉造影有助于患者的选择。