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目的探讨紧贴肝门大血管的肝癌手术经验与提高术后疗效。方法自1990年1月至1997年6月间,经作者手术切除的肝门区(Ⅰ、Ⅳ、Ⅴ、Ⅷ肝段)肿瘤中,选择了紧贴肝内主干血管(腔静脉肝后段、主肝静脉根部、门静脉左右干)1cm以内的肝癌58例,肿瘤直径≤5cm16例,>5cm42例,最大者为20cm×18cm×18cm,对其手术方法、并发症防治等进行总结分析。结果全组病例手术经过顺利,随访至今,术后1、3、5年生存率分别为71%、38%和25%。结论虽然此类手术难度大、风险大,只要重视手术方法改进、并发症防治和术后综合治疗,仍可提高手术安全性和术后疗效
Objective To explore the surgical experience and improve the postoperative efficacy of liver cancer that closely adheres to the hepatic portal vein. Methods From January 1990 to June 1997, the hepatic portal vein (I, IV, V, and VIII liver segments) tumors that were surgically resected by the author were selected to adhere to the main hepatic veins (the posterior segment of the vena cava. The main hepatic veins and the portal veins were dried in 58 cases within 1cm. The tumor diameter was ≤5cm in 16 cases, >5cm in 42 cases, and the largest was 20cm in 18cm in 18cm. Surgical methods and prevention of complications were analyzed. Results The operation of the whole group was successful and the follow-up to date, the 1, 3, and 5-year survival rates were 71%, 38%, and 25%, respectively. Conclusion Although this type of surgery is difficult and risky, surgical safety, postoperative efficacy can still be improved as long as surgical methods are improved, complications are prevented, and postoperative comprehensive treatment is emphasized.