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目的 介绍用肝门区域血管阻断法切除最大径 1 0～ 30cm且经病理证实的肝细胞癌 96例的经验、复发的相关因素和疗效。方法 用肝门血管解剖法游离阻断相应血管如肝右叶或右叶多亚段切除阻断肝动脉(HA)和门静脉 (PV)右支 (5 4例次 )、中叶切除阻断HA和PV右前支和HA和PV左内支 (1 9例次 )、左叶切除阻断HA和PV左支 (1 1例次 ) ,左外段切除阻断HA和PV左外支 (1 5例次 )。结果 ①手术死亡率 3 1 % ;②复发率 70 % ;③ 5年、3年、2年、1年生存率分别为 1 3 5 %、33 3%、42 8%、85 1 %。结论 本法提高了巨大肝癌的切除率和手术安全性 ,延长了中晚期病人的生存时间 ,术后经泵局部化疗 2年以防治同一细胞克隆肝癌复发 ,干扰素注射可能预防不同细胞克隆的肝癌再生
Objective To introduce the experience, recurrence related factors and curative effect of 96 cases of pathologically confirmed hepatocellular carcinoma with a hepatic portal vein occlusion method with a maximum diameter of 10-30 cm. Methods The hepatic vascular anatomy method was used to block the corresponding vessels, such as the right hepatic lobe or multi-subsection of the right lobe. The hepatic artery (HA) and the right branch of the portal vein (PV) were blocked (54 cases), and the middle lobectomy blocked the HA. PV right anterior branch and left internal branch of HA and PV (19 cases), left lobectomy and left branch of HA and left PV branch (11 times), left external segment resection and left external branch of HA and PV (15 cases) Times). Results 1 The operative mortality was 31%; 2 The recurrence rate was 70%; The 35 years, 3 years, 2 years, and 1 year survival rates were 135%, 33%, 428%, and 851%, respectively. Conclusion This method improves the resection rate and surgical safety of hepatocellular carcinoma and prolongs the survival time of patients in the middle and advanced stages. After local chemotherapy with pump for 2 years to prevent the recurrence of hepatocellular carcinoma with the same cell clone, interferon injection may prevent hepatocellular carcinoma with different cell clones. regeneration