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目的探讨我国肝移植治疗原发性肝癌的手术适应证及效果。方法回顾性分析我院1999年2月至2004年连续施行的170例原位肝移植手术,对其中原发性肝癌62例的临床分期,手术方式及术后长期生存情况等进行分析,探讨手术指征及效果。结果62例肝癌肝移植病人,随访1~39个月,住院期间死亡4例(6·45%),存活病例1、2、3年肿瘤复发转移率分别为29·31%,41·38%,58·06%;1、2、3年生存率分别为87·45%,65·59%,42·06%,进一步分析发现肿瘤直径<5cm者6例,全部无瘤生存;肿瘤伴门静脉主干癌栓者7例,除1例无瘤生存1年2个月外余均于1年内复发或死亡。结论晚期肝癌尚无门静脉主干癌栓者可作为我国肝移植指征,应进一步探索围手术期防治肝癌复发转移措施,进一步提高我国肝癌肝移植的疗效。
Objective To investigate the indications and effects of surgical treatment of primary liver cancer in China. Methods Retrospective analysis of 170 cases of orthotopic liver transplantation performed in our hospital from February 1999 to 2004 were retrospectively analyzed. The clinical stage, operation method and long-term survival of 62 cases of primary liver cancer were analyzed. Surgical operation Indications and effects. Results Sixty-two patients with liver cancer who underwent liver transplantation were followed up for 1 to 39 months. Four patients died during hospitalization (6.45%). The recurrence and metastasis rates at 1, 2 and 3 years of survivors were 29.31% and 41.38% , 58.06%; 1, 2, 3-year survival rates were 87.45%, 65.59%, 42.06%, further analysis found that tumor diameter <5cm in 6 cases, all tumor-free survival; tumor with portal vein The main tumor thrombus in 7 cases, except 1 case of tumor-free survival of 1 year and 2 months, the remaining were within 1 year recurrence or death. Conclusions Advanced hepatocellular carcinoma without portal vein tumor thrombus can be used as an indication of liver transplantation in our country. Perioperative measures to prevent recurrence and metastasis of hepatocellular carcinoma should be further explored to further improve the efficacy of liver transplantation in China.