摘要
目的 探讨位于肝中央区肝肿瘤手术切除的安全性和可行性。方法 回顾性分析近 6年经手术切除位于肝中央区的肝肿瘤 3 6例的临床资料 ,其中肝癌 2 6例 ,良性肿瘤 10例。肿瘤累及第一肝门者 13例 ,第二肝门 10例 ,第三肝门 5例 ,同时累及第一和第三肝门 3例 ,第二和第三肝门 5例。结果 全组术中并发大出血 4例 (11.1% ) ,术后发生并发症 11例 (3 0 .5 % ) ,包括肝衰竭 1例(2 .7% ) ,胆瘘 2例 (5 .5 % ) ,胸腔积液 6例 (16.7% ) ,膈下感染 1例 (2 .7% ) ,腹壁切口疝 1例(2 .7% ) ;除 1例因急性肝衰竭术后死亡外 ,余均恢复出院。结论 此类手术难度大、风险大 ,只要术前重视适应证的选择 ,术中妥善处理 ,仍可成功切除肿瘤 ,减少并发症的发生。
Objective To evaluate the feasibility and safety of resection of tumors in hepatic centric area. Methods The clinical data of 36 patients with tumors in hepatic centric area treated by resection in our hospital from Jan 1996 to Dec 2001 were retrospectively analyzed. In this series,there were 26 cases of liver cancer and 10 cases of benign tumor. Of the 36 patients,the tumor involved the first porta hepatis in 13 cases, involved the second porta hepatis in 10 , involved the third porta hepatis in 5 , involved both the first and second porta hepatis in 3, and involved both the second and third porta hepatis in 5 cases. Results During the operation, massive hemorrhage occurred in 4 cases(11.1%). Postoperative complications occurred in 11 patients(30.5%),including liver function failure in 1 case (2.7%), biliary fistula in 2 cases (5.5%), pleural effusion in 6 cases (16.7%), subphrenic infection in 1 case (2.7%),and abdominal incisional hernia in 1 case (2.7%). All patients recovered except that one died of acute hepatic failure after the operation. Conclusions Although the surgery for this tumor is quite difficult and risky, if enough attention is paid to the choice of the patient,and the meticulous surgical technique,the operation safety and therapeutic result of the operation could be improved.
出处
《中国普通外科杂志》
CAS
CSCD
2003年第3期166-168,共3页
China Journal of General Surgery
