Starzl T E, Koep L J, Weil R, Lilly J R, Putnam C W, Aldrete J A
Surg Gynecol Obstet. 1980 Feb;150(2):208-14.
Thirty patients had right trisegmentectomy for 19 primary hepatic malignant tumors, seven localized liver metastases and four benign lesions. A technical refinement that aided resection of bulky posterior and superior tumors was intrahepatic identification and control of the right hepatic vein. The operative mortality was 3.3 per cent. Late hepatic insufficiency was not observed. More than one-half of the patients operated upon a year or more ago for primary hepatic malignant growths had a tumor-free state at the 12 month follow-up period. Beyond this time, there was only one recurrence. The results in children were twice as good as in adults. The results in treating localized liver metastases from distant primary sites were inferior to those in treating primary hepatic tumors. A hypothetical case was made for combining hepatic resection with adjuvant chemotherapy, even though our experience could not be construed as direct support for this practice.
30例患者因19例原发性肝脏恶性肿瘤、7例局限性肝转移瘤和4例良性病变接受了右半肝切除术。一项有助于切除体积较大的后部和上部肿瘤的技术改进是在肝内识别和控制右肝静脉。手术死亡率为3.3%。未观察到晚期肝功能不全。一年或一年以上前因原发性肝脏恶性肿瘤接受手术的患者中，超过一半在12个月随访期处于无瘤状态。超过这个时间，仅出现1例复发。儿童的治疗结果是成人的两倍。治疗远处原发部位的局限性肝转移瘤的结果不如治疗原发性肝脏肿瘤的结果。尽管我们的经验不能直接支持这种做法，但我们提出了一个将肝切除与辅助化疗相结合的假设病例。
