Nagahama T, Goseki N, Kato S, Maruyama M, Endo M
Department of Surgery, Tokyo Metropolitan Komagome Hospital, Japan.
Arch Surg. 1996 Feb;131(2):208-10. doi: 10.1001/archsurg.1996.01430140098024.
We have experience with two cases in which esophageal carcinoma and coexisting hepatocellular carcinoma were resected simultaneously. One patient had advanced esophageal carcinoma located in the thoracic esophagus and solitary hepatoma in the posterior segment of the liver with normal liver function. The other patient had superficial esophageal carcinoma in the thoracic esophagus and solitary hepatoma in the posterior segment of the liver with impaired liver function. Subtotal resection of the esophagus and posterior segmentectomy of the liver were performed simultaneously in both patients. In the patient with impaired liver function, postoperative management of respiration and bleeding was difficult, and intensive care was needed. Mediastinal lymph node resection was modified. Postoperative course was considered to have a close relationship to liver function. Thus, close evaluation of liver function is important to decide suitable treatment of patients with primary hepatocellular carcinoma and coexisting malignant neoplasms. With close evaluation of liver function and intensive postoperative care, simultaneous resection of esophageal carcinoma and hepatocellular carcinoma is not impossible or difficult.
我们有两例同时切除食管癌和并存肝细胞癌的经验。一例患者患有位于胸段食管的进展期食管癌和肝功能正常的肝脏后段孤立性肝癌。另一例患者患有胸段食管浅表性食管癌和肝功能受损的肝脏后段孤立性肝癌。两例患者均同时进行了食管次全切除术和肝脏后段切除术。肝功能受损的患者术后呼吸和出血管理困难，需要重症监护。纵隔淋巴结切除术进行了改良。术后病程被认为与肝功能密切相关。因此，密切评估肝功能对于决定原发性肝细胞癌合并其他恶性肿瘤患者的合适治疗方法很重要。通过密切评估肝功能和加强术后护理，同时切除食管癌和肝细胞癌并非不可能或困难。
