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1、中華普通外科雜志2014年1月第29卷第1期ChinJGenSurg,January2014,Vo1.29,No.1·13·.論著.解剖性肝中葉切除治療中央型肝癌王永剛吳金術(shù)蔣波劉初平沈賢波彭創(chuàng)田秉璋【摘要】目的探討解剖性肝中葉切除治療中央型肝癌的可行性及近期療效。方法回顧性分析2007年1月至2011年12月收治的85例原發(fā)性中央型肝癌(單發(fā),無遠(yuǎn)處轉(zhuǎn)移),按照手術(shù)方式分為解剖性肝中葉切除術(shù)組(A組)共36例,非解剖性肝中葉切除術(shù)組(B組)共49例,比較手術(shù)策略,術(shù)中情況,術(shù)后并發(fā)癥及近期復(fù)發(fā)轉(zhuǎn)移情況。結(jié)果2組術(shù)中出血量差異無統(tǒng)計(jì)學(xué)意義(P>0.05)
2、;各組術(shù)中輸血量差異無統(tǒng)計(jì)學(xué)意義(P>0.05);A組術(shù)后住院時(shí)間及總住院費(fèi)用明顯優(yōu)于B組(P<0.05);A組手術(shù)時(shí)間較B組長,2組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05);并發(fā)癥發(fā)生人數(shù)和發(fā)生人次2組有明顯統(tǒng)計(jì)學(xué)差異;A組復(fù)發(fā)轉(zhuǎn)移7例,占該組的19.4%(7/36);而非解剖組復(fù)發(fā)轉(zhuǎn)移20例,占該組的40.8%(20/49),2組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論解剖性肝中葉切除具有手術(shù)打擊小,術(shù)中出血少,術(shù)后滲出及并發(fā)癥少,復(fù)發(fā)轉(zhuǎn)移率低等優(yōu)點(diǎn),可作為治療中央型肝癌的首選手術(shù)方式?!娟P(guān)鍵詞】癌,肝細(xì)胞;肝切除術(shù)Anatomicalmesohepa
3、tectomyforcentralhepatoeellularcarcinomaWangYonggang,WuJinshu,JiangBo,LiuChuping,ShenXianbo,PeChuang,TianBingzhang.DepartmentofHepatobiliarySurgery,HunanProvincialPeopleSHospital,Changsha410005,ChinaCorrespondingauthor:WuJinshu,E—mail:wjs@126.corn【Abstract】ObjectiveTocomparetheef
4、ficaciesofanatomicandnonanatomicmesohepatectomyforcentraltypehepatocellularcarcinoma.MethodsTheclinicaldataof85patientswithcentraltypehepatocellularcarcinomaundergoinghepatectomieswereretrospectivelyanalysed.36patientsunderwentanatomicmesohepatectomyandtheother49patientsdidnonana
5、tomicmesohepatectomy.Theoperativetime,intraoperativebloodloss,incidenceofpostoperativecomplications,postoperativedrainagevolume,timetoflatusandlengthofpostoperativestaybetweenthetwogroupswerecompared.ResultsTherewerenosignificantdifferencesinthegeneralcondition.organfunction.tumo
6、rsizeandlocationbetweenthetwogroupsbeforeoperation(P>0.05).Theintraoperativebloodloss,incidenceofpostoperativecomplications,drainagevolumeweresignificantlylessbuttheoperativetimelongerinanatomicmes0hepatect0mygroupthannonanatomichepatectomygroup(P<0.05).Nodifferencesbetweenthetwo
7、groupsweref0undinregardtothetimeforflatusandlengthofpostoperativehospitalstay(P>0.05).Tumorrecurrencedevelopedin7casesingroupAand20casesingroupB(P<0.05).ConclusionsAnatomicmesohepatectomyhastheadvantagesoflesssurgicaltrauma,lessexudationandcomplicationsinpatientswithcentraltypehe
8、patocellularcarcinoma.【Keywords】Carcinom