Greif F, Papo J, Kessler A, Oron D, Konokov F, Bartal G, Lelcuk S
Surgical Dept. B, Beilinson Medical Center, Petah Tikvah.
Harefuah. 1995 Mar 15;128(6):349-51, 400.
Major hepatic resection is the treatment of choice in patients with primary and secondary liver cancer. During a 22-month period 31 men and 27 women (mean age 63 years, range 14-84) with space-occupying hepatic lesions were admitted. All 15 patients with benign lesions were operated, except for 3 in whom a liver abscess was drained percutaneously. Of the 43 with malignant liver lesions, 30 had liver metastasis secondary to colorectal cancer, 15 of whom underwent major, anatomical and nonanatomical, liver resection and 1 had cryoablation of the tumor. 9 had hepatocellular carcinoma, 1 of whom had a 4-segment non-anatomical resection and 1 tumor cryoablation. 2 with metastasis from a neuroendocrine tumor had anatomical resection of liver lobes. Of 2 with liver metastasis secondary to breast cancer, 1 underwent resection. CT portography, intraoperative ultrasonography and intraarterial injection of Lipiodol were found to be very useful in selecting patients for liver resection.
肝大部切除术是原发性和继发性肝癌患者的首选治疗方法。在22个月的时间里，收治了31名男性和27名女性（平均年龄63岁，范围14 - 84岁）患有肝脏占位性病变的患者。15例良性病变患者均接受了手术治疗，其中3例经皮引流肝脓肿。43例恶性肝病变患者中，30例为结直肠癌肝转移，其中15例行肝大部切除术，包括解剖性和非解剖性肝切除术，1例行肿瘤冷冻消融术。9例为肝细胞癌，其中1例行4段非解剖性切除术，1例行肿瘤冷冻消融术。2例神经内分泌肿瘤肝转移患者行肝叶解剖性切除术。2例乳腺癌肝转移患者中，1例行切除术。CT门静脉造影、术中超声检查和肝动脉内注射碘油被发现对选择肝切除患者非常有用。
