原发性肝癌合并下腔静脉癌栓的手术治疗

目的：探讨原发性肝癌合并下腔静脉癌栓的手术治疗方法。方法：采用肝切除加下腔静脉取栓治疗2例肝癌合并下腔静脉癌栓患者,取栓方法包括经荷栓肝静脉取栓（1例）和下腔静脉切开取栓（1例）,又分在全肝血流阻断下取栓和在萨氏钳局部血管阻断下取栓。结果：2例肝癌及下腔静脉癌栓均得到成功切除,术中无明显并发症发生;术后无死亡;随访中一例存活11月;另1例已生存8个月。结论：肝癌合并下腔静脉癌栓的手术治疗安全可行,其基本术式为肝切除加下腔静脉切开取栓。

Surgical Treatment of Primary Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava

Objective： To clarify the proper surgical procedure of treating primary hepatocellular carcinoma（HCC） with a tumor thrombus in the inferior vena cava（IVC）.Methods： Two patients with PHCC with a tumor thrombus in the IVC underwent hepatectomy and thrombectomy.Following hepatectomy,tumor thrombus was removed by incising the wall of the IVC in 1 patient and from the hepatic vein in the other patient.The patients underwent thrombectomy under either total hepatic vascular exclusion（THVE） or Satinsky＇s vascular clamping.Results： All the operations were successful without operative death and major complications.The postoperative course was uneventful in the patients and pleural effusion occurred in one patient who needed thoracentesis.Follow-up showed one patient is alive months,and the other patient is alive for 8 months.Conclusions： PHCCwith tumor thrombus in the IVC is operable and the proper procedure is hepatectomy plus thrombectomy.