解剖性肝中叶切除治疗中央型肝癌.pdf

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1、中华普通外科杂志2014年1月第29卷第1期ChinJGenSurg，January2014，Vo1．29，No．1·13·．论著．解剖性肝中叶切除治疗中央型肝癌王永刚吴金术蒋波刘初平沈贤波彭创田秉璋【摘要】目的探讨解剖性肝中叶切除治疗中央型肝癌的可行性及近期疗效。方法回顾性分析2007年1月至2011年12月收治的85例原发性中央型肝癌(单发，无远处转移)，按照手术方式分为解剖性肝中叶切除术组(A组)共36例，非解剖性肝中叶切除术组(B组)共49例，比较手术策略，术中情况，术后并发症及近期复发转移情况。结果2组术中出血量差异无统计学意义(P>0．05)

2、；各组术中输血量差异无统计学意义(P>0．05)；A组术后住院时间及总住院费用明显优于B组(P<0．05)；A组手术时间较B组长，2组比较差异有统计学意义(P<0．05)；并发症发生人数和发生人次2组有明显统计学差异；A组复发转移7例，占该组的19．4％(7／36)；而非解剖组复发转移20例，占该组的40．8％(20／49)，2组比较差异有统计学意义(P<0．05)。结论解剖性肝中叶切除具有手术打击小，术中出血少，术后渗出及并发症少，复发转移率低等优点，可作为治疗中央型肝癌的首选手术方式。【关键词】癌，肝细胞；肝切除术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