Ma Z M, Feng Y Z, Zhou X R
First Affiliated Hospital, Zhejiang Medical University, Hangzhou.
Zhonghua Wai Ke Za Zhi. 1994 Jan;32(1):31-4.
From Sep. 1985 to Dec. 1990, surgical treatment was performed in 27 patients with small primary liver cancer (SPLC, < or = 5cm in diameter). Of them, segmentectomy was done in 23 cases and radical local resection in 4 cases with recurrence rate of 66.77% (18/27). Non recurrent lesions were located in the incisal margin. In this group re-resection rate was 55.6% (10/18). (1) Early detection and treatment of recurrent lesions remain a mainstay of prolonging survival. (2) Serum Alpha-fetoprotein (AFP), ultrasonography and X-ray chest film were basic follow-up methods for subclinical recurrence of SPLC. For re-operation cases, digital subtract angiography (DSA) are useful in identifying subclinical lesions. (3) For recurrent liver cancer local hepatectomy was a reasonable approach. (4) For SPLC, radical segmentectomy or radical local resection with a safe margin of 1 to 2cm was the authors' choice.
1985年9月至1990年12月，对27例原发性小肝癌（直径≤5cm）患者实施了手术治疗。其中，23例行肝段切除术，4例行根治性局部切除术，复发率为66.77%（18/27）。未复发的病灶位于手术切缘。该组再次手术率为55.6%（10/18）。（1）复发病灶的早期发现与治疗仍是延长生存期的关键。（2）血清甲胎蛋白（AFP）、超声检查及胸部X线片是原发性小肝癌亚临床复发的基本随访方法。对于再次手术的病例，数字减影血管造影（DSA）有助于识别亚临床病灶。（3）对于复发性肝癌，局部肝切除术是一种合理的方法。（4）对于原发性小肝癌，作者选择行根治性肝段切除术或切缘安全距离为1至2cm的根治性局部切除术。
