【摘要】 目的:探讨大肝癌实施规则性肝段切除能否提高大肝癌术后的无瘤生存率和总体生存率。方法:回顾性分析本院2000年1月～2004年12月实施的大肝癌规则性肝段切除病例的手术情况,1、3、5年的无瘤生存率及总体生存率进行分析并与同期实施不规则肝切除术的患者比较。结果:实施规则性肝段切除的患者术后1、3、5年总体生存率分别为90.0%、62.5%、47.5%;术后1、3、5年无瘤生存率分别为75.0%、50.0%、30.0%。实施不规则性肝段切除的患者术后1、3、5年总体生存率分别为90.9%、65.5%、49.1%,术后1、3、5年无瘤生存率分别为80.0%、47.3%、27.3%。两组之间比较无统计学上显著性差异。结论:虽然从肿瘤学上来讲规则性肝段切除比不规则性肝切除更具有优势,但在临床实践中并不能提高术后的无瘤生存率和总体生存率,肝癌肝切除术后的无瘤生存率和总体生存率可能同受损的肝脏本身情况有关。更多还原

【Abstract】 Objective: To discuss the possibility for enhancement of tumor-free and overall survival rates after segmental hepatotectomy. Methods: Data of 175 patients undergoing radical hepatectomy to remove primary large hepatocellular carcinoma (> 5 cm) at our hospital between January 2000 and December 2004 were retrospectively analyzed. The 1, 3 and 5-year tumor-free and overall survival rates of these cases were analyzed, and a comparison was conducted between the patients of the same period with the segmental and nonanatomical hepatectomy. Results: After implementation of the segmental hepatectomy, the 1, 3 and 5-year overall survival rates were 90%, 62.5% and 47.5% and the 1, 3 and 5-year postoperative tumor-free rates were 75%, 50% and 30%, respectively. After nonanatomical hepatectomy, the 1, 3 and 5-year overall survival rates were 90.9%, 65.5% and 49.1% and the 1, 3 and 5-year postoperative tumor-free rates were 80%, 47.3% and 27.3%, respectively. There was no significant difference between the two surgical methods. Conclusion: Although segmental hepatectomy seems to be superior to nonanatomical hepatectomy based on oncological and anatomical theory, it still fails to improve the postoperative tumor-free and overall survival rates in clinical practice. These survival rates might be related to damage of the liver.更多还原