论文部分内容阅读
目的总结原位肝脏移植治疗Klatskin瘤的适应证及临床疗效。方法选取1992年1月至2003年12月实施的240例原位肝脏移植中的5例Klatskin瘤患者,并与同期具有可比性的采用非移植治疗的35例Klatskin瘤患者进行对比分析。结果肝脏移植组5例患者手术切除率和根治切除率均为100%,除1例因并发症于术后40d死亡外,余均健康存活,现已分别存活48,38,21和5个月,生活质量良好,未见明确肿瘤复发和转移;1、3年累积生存率均为4/5。非移植方法治疗组手术切除率和根治切除率分别为63.0%(17/27)和40.7%(11/27),1,3,5年累积生存率分别为32.2%,8.0%和0,与肝脏移植组相比,在根治切除及生存率方面两组差异有统计学意义(P=0.016)。但非移植方法治疗组行根治切除患者的1,3年累积生存率分别为54.5%(6/11)和18.2%(2/11),与肝脏移植组相比无显著差异(P=0.164)。结论常规无法根治切除的Klatskin瘤是原位肝脏移植的适应证,术后长期疗效满意。
Objective To summarize the indications and clinical effects of orthotopic liver transplantation for Klatskin’s tumor. Methods Five patients with Klatskin’s tumor from 240 patients with orthotopic liver transplantation performed from January 1992 to December 2003 were selected and compared with 35 patients with Klatskin treated with nontransplantation at the same period. Results All the 5 patients in the liver transplantation group had 100% surgical resection rate and radical resection rate. Except one case died of complications at 40 days after operation, all survived well and survived for 48, 38, 21 and 5 months respectively , Good quality of life, no clear tumor recurrence and metastasis; 1, 3-year cumulative survival rate was 4/5. The rates of resection and radical resection in the non-transplantation group were 63.0% (17/27) and 40.7% (11/27), respectively. The cumulative survival rates at 1, 3 and 5 years were 32.2%, 8.0% and 0, respectively Compared with the liver transplantation group, there was significant difference between the two groups in radical resection and survival (P = 0.016). However, the 1-year and 3-year cumulative survival rates were 54.5% (6/11) and 18.2% (2/11) in patients who underwent radical resection in the nontransplantation group, respectively, which were not significantly different from those in the liver transplantation group (P = 0.164) . Conclusion Conventional incurable Klatskin tumor is an indication of orthotopic liver transplantation. Long-term curative effect is satisfactory.