中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (44): 8357-8360.doi: 10.3969/j.issn.1673-8225.2010.44.046

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    

原位肝移植治疗原发性肝癌

张  坤，江  艺，吕立志，张小进，杨  芳，陈永标，蔡秋程，潘  凡   

  • 出版日期:2010-10-29 发布日期:2010-10-29
  • 通讯作者: 江艺，博士，教授，主任医师，博士生导师，解放军南京军区福州总医院肝胆外科，福建医科大学福总临床医学院肝胆外科，福建省福州市 350025
  • 作者简介:张坤☆，男，1973年生，山东省沂水县人，汉族，2004年解放军第三军医大学毕业，博士，主治医师，讲师，主要从事消化系肿瘤及肝移植方向的研究。

Orthotopic liver transplantation for primary hepatic cancer

  • Online:2010-10-29 Published:2010-10-29
  • Contact: Jiang Yi, Doctor, Professor, Chief physician, Doctoral supervisor, Department of Hepatobiliary Surgery, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA, Fuzhou 350025, Fujian Province, China
  • About author:Zhang Kun☆, Doctor, Attending physician, Lecturer, Department of Hepatobiliary Surgery, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA, Fuzhou 350025, Fujian Province, China zhangkun73@yahoo.com.cn

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摘要：

背景：肝移植可完整切除病肝，远期疗效优于肝切除，其5年存活率可达70%H1。此外，肝移植还可避免在肝功能不良的情况下肝切除带来的术后肝功能不全的严重风险。
目的：回顾性分析原发性肝癌原位肝移植治疗效果及意义。
方法：对解放军南京军区福州总医院肝胆外科1980-03/2008-12因原发性肝癌行原位肝移植术患者75例术后生存及肿瘤复发情况进行总结分析。
结果与结论：75例患者术后1, 2, 3年的总体生存率及无瘤生存率分别为: 86.6%, 66.7%, 53.3%及65.2%, 53.9%, 34.1%,平均生存时间25个月。其中符合Milan标准的手术患者术后1, 2, 3年的总体生存率及无瘤生存率分别为: 88.4%, 72.5%, 57.9%及77.6%, 62.3%, 51.8%,平均生存时间39个月。超出Milan标准的6例患者均在术后1年内出现肿瘤的复发，有2例患者在术后1年内死亡，术后1年生存率为66.7%。其余4例患者于术后2年内相继死亡。平均生存时间14个月。提示原位肝移植是原发性肝癌的有效治疗方法之一，选择符合Milan标准的原发性肝癌患者行肝移植手术治疗将会取得最佳疗效。

Abstract:

BACKGROUND: The affected liver can be completely removed by liver transplantation, long-term efficacy is superior to liver resection, the 5-year survival rate reaches 70% H1. In addition, liver transplantation can avoid a serious risk for incomplete liver function caused by hepatic resection in the case of liver dysfunction.
OBJECTIVE: To retrospectively analyze the treatment effects and importance of orthotopic liver transplantation for primary hepatic cancer patients.
METHODS: A total of 75 patients with primary hepatic cancer treated by orthotopic liver transplantation in Department of Hepatobiliary Surgery, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from March 1980 to December 2008 were involved in the analysis for the postoperative survival rates and recurrence of tumors.
RESULTS AND CONCLUSION: For all the patients, the total postoperative survival rate in the 1st, 2nd and 3rd year was 86.6%, 66.7% and 53.3% respectively, the disease free survival rate was 65.2%, 53.9%, 34.1%. Their mean survival time is 25 months. For the patients in line with Milan standard, the postoperative survival rate in the 1st, 2nd and 3rd year was 88.4%, 72.5% and 57.9% respectively, the disease free survival rate was 77.6%, 62.3%, 51.8%. Their mean survival time is 39 months. Tumor recurrence occurred within one year in all six patients who were beyond Milan standard. Two patients died in one year after operation, the survival rate at postoperative one year was 66.7% and the remanent four patients all died in the 2nd year after operation. Orthotopic liver transplantation was one of the effective treatments for primary hepatic cancer patients. The patients which were measured up to Milan standard would have the best curative effects.

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