探讨精准肝切除在原发性肝癌合并门静脉癌栓中的应用价值。

回顾性分析2013年1月至2014年8月在中山市人民医院行精准肝切除术治疗的10例原发性肝癌合并门静脉癌栓患者的临床资料。记录和观察患者的手术时间、术中出血量、术后并发症、术后住院时间及随访情况。

全部患者均顺利完成手术，肿瘤切除后切缘均为阴性，患者无围手术期死亡。手术时间为（292±45）min，术中出血量为（365±81）ml，术后住院时间为（13±3）d。术后发生胸腔积液2例，经保守治疗治愈。2例分别于术后4个月、5个月发生肿瘤复发并死亡，其余恢复良好。

精准肝切除术应用于原发性肝癌合并门静脉癌栓是安全、有效的，具有术中出血少、并发症发生率低、术后康复快的优势。

To investigate the application value of precise hepatectomy in primary liver cancer with portal vein tumor thrombi.

Clinical data of ten patients were analyzed retrospectively of liver cancer combined with portal vein tumor thrombi undergoing precise hepatectomy in Zhongshan City People’s Hospital between January 2013 and August 2014. The operation time, intraoperative hemorrhage volume, postoperative complications, postoperative length of hospital stay and follow-up data were recorded.

Hepatectomy was performed successfully in all patients. The incisional margins were detected as negative after tumor resection. No patients died during the perioperative period. The mean operation time was (292±45) min, intraoperative hemorrhage volume was (365±81) ml, postoperative length of hospital stay was (13±3) d. Two cases of pleural effusion postoperatively were cured by conservative treatment. Two patients suffered from tumor recurrence 4 months and 5 months after surgery respectively and died, and the rest recovered well.

The application of precise hepatectomy in primary liver cancer with portal vein tumor thrombi is safe and effective, with advantages of less intraoperative hemorrhage, lower incidence of complications, and faster postoperative recovery.