摘要 回顾性总结36例巨大肝癌手术切除的有关手术技术、疗效及围手术期处理等问题。本组病例肝癌病灶位于右半肝20例，左半肝14例，左右肝叶2例；肿瘤直径10cm～15cm 27例，直径>15cm9例，切除肝标本重740～3500g，平均1160g。全组无手术死亡。术后半年、1年、3年生存率分别为94.4%(34/36)，69.4%(25/36)、18.5%(5/27)。5年生存率为0。认为手术切除巨大肝癌可延长病人生存时间，但其远期疗效尚不满意。术后3年内为复发的高危期。手术切除要抓好术前准备，术中操作和术后处理三个环节。

Excision for giant primary hepatic carcinoma: a retrospective summary of 36 cases

Zhao Feng Chen Shanrong Wei Zhongheng

Department of surgery, Affiliated Hospital of Youjiang Medical College

for Nationalities, Baise, Guangxi, P.R.China 533000

The operative technique, efficacy, and intraoperative manipulation of excision for giant primary hepatic carcinoma from 36 patients were retrospectively summarized. The foci of hepatic carcinoma of 20 cases located in right hemihepar, 14 in left, 2 in left and right hepatic lobes; and the neoplasm diameters of 27 cases were from 10cm to 15cm, 9 over 15cm, the excised hepatic specimen weighed from 740 to 3500g, mean weihgt 1160g. None of operative death. The postoperative survival rates of half a year, one year, and 3 year were 94.4 percent (34/36), 69.4 percent (25/36), and 18.5 percent (5/27), respectively. 5- year survival rate was 0. It indicated that the excision can prolong the patients' lives, but long-term follow-up results were not satisfactory. The high risk recurrent period was in 3 years after operation. Three steps for the excision, i.e. preoperative preparation, intraoperative manipulation, and postoperative treatment should be paied attention to.

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