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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。
Background: Liver transplantation can completely remove diseased liver, and the long-term curative effect is better than that of hepatectomy. The 5-year survival rate can reach 70%. In addition, liver transplantation also avoids the serious risk of postoperative liver dysfunction caused by liver resection in the case of liver dysfunction. Objective: To retrospectively analyze the curative effect and significance of orthotopic liver transplantation for primary liver cancer. Methods: 75 cases of postoperative survival and tumor recurrence in patients with hepatocellular carcinoma undergoing orthotopic liver transplantation undergoing hepatobiliary surgery from March 1980 to December 2008 in Fuzhou General Hospital of PLA, Nanjing Military Area Command were summarized. RESULTS AND CONCLUSION: The overall survival rate and tumor-free survival rate at 1, 2 and 3 years after operation in 75 patients were 86.6%, 66.7%, 53.3% and 65.2%, 53.9% and 34.1%, respectively. The mean survival time was 25 month. Among them, the overall survival and tumor-free survival at 1, 2 and 3 years after surgery were respectively 88.4%, 72.5%, 57.9% and 77.6%, 62.3% and 51.8%, and the average survival time was 39 month. All 6 patients who exceeded the Milan standard developed tumor recurrence within one year after surgery. Two patients died within one year after operation and the one-year survival rate was 66.7%. The remaining 4 patients died within 2 years after surgery. The average survival time of 14 months. Prompted orthotopic liver transplantation is one of the effective treatment of primary liver cancer, choose to meet the standard of primary liver cancer patients with liver transplantation liver transplantation surgery will achieve the best effect.