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Primary liver tumor location on the impact of surgery and surgical clinical analysis methods

Author: YuLiHan
Tutor: FangXueDong
School: Jilin University
Course: Clinical
Keywords: HCC Hepatectomy Hepatic vascular exclusion
CLC: R735.7
Type: Master's thesis
Year: 2011
Downloads: 40
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Abstract

Means the occurrence of primary liver parenchymal cells in the liver or bile duct cell malignancies (hereinafter referred to as liver cancer). Is one of common human malignancies. Currently, cancer cause of death in the world in fourth place, and the incidence is rising in recent years. Liver cancer is often accompanied by a variety of local and systemic symptoms, patients with poor prognosis. Today, the treatment of liver cancer has been formed to surgical treatment combined with a variety of other treatments such as hepatic arterial chemoembolization, percutaneous ethanol injection, radiofrequency thermal coagulation, microwave therapy, cryoablation therapy, radiation therapy, biological therapy and molecular targeted therapy integrated treatment model. The surgery is considered the most effective treatment is the most critical. Studies have shown that the amount of bleeding hand hepatectomy patients the incidence of postoperative complications and prognosis, affecting postoperative residual liver cell regeneration of important factors. How does not cause systemic hemodynamics, avoiding intrahepatic blood transfer effective control of bleeding while to reduce the incidence of postoperative complications, is conducive to recovery and regeneration of liver function is currently a hot issue in liver surgery a. At present, the liver is a blood vessel occlusion techniques based on anatomical and selective control of hepatic blood flow, to a certain extent, reduce intraoperative bleeding section. Such as the first portal vascular occlusion, semi hepatic hepatic inflow occlusion, semi hepatic blood flow is completely blocked law. But because the liver blood rich in blood vessels branching complexity, tissue fragility, blocking the hepatic portal vein and hepatic arterial blood flow after surgery is still bleeding occur, affecting the patient recovered. In this paper, a retrospective analysis, comparing different hepatic vascular occlusion surgery and different ways on the surgical process and the postoperative recovery of short-term implications for the choice of procedure intraoperative and perioperative ready reference. Objective: A retrospective study in liver resection and vascular occlusion tumor location on the surgical process and the way the impact of postoperative recovery, choice of procedure for the intraoperative and perioperative ready reference. Methods: Jilin University General Surgery disease treatment center from August 2008 to February 2011 were treated in parallel during surgery, postoperative pathology returns in line for 53 cases of primary liver cancer were retrospectively analyzed, divided into left liver group ( n = 20) and right liver group (n = 33). In operative time, intraoperative blood transfusion, postoperative hospital stay, postoperative 1,3,7 days alanine aminotransferase, albumin, total bilirubin, and cholinesterase situation as the reference index, were compared different occlusion methods and where half of the liver tumors in different positions on the impact of surgery and postoperative. Data results are applied SPSS13.0 statistical software, measurement data with x ± s said, using independent sample t-test and ANOVA; count data using the X2 test, where P lt; 0.05 indicates significant difference. (A) between different groups, age, gender, tumor size, preoperative Child-Pugh score there was no significant difference (P gt; 0.05). (2) Application of a first hepatic vascular occlusion, left and right lobe liver group between the two groups after the first three days, the first seven days of total bilirubin differences (p lt; 0.05); application hemihepatic hepatic inflow occlusion, right liver operative time, postoperative hospital stay was significantly longer than the left liver (p lt; 0.05); application of local vascular occlusion, a large amount of blood transfusion right liver group ( p lt; 0.05), between the two groups after the first seven days of total bilirubin differences (p lt; 0.05). Right liver left lobe group other indexes between the groups were not significantly different (p gt; 0.05). (3) in the local hepatic vascular exclusion method, the first hepatic vascular occlusion and semi-hepatic vascular occlusion three kinds of blocking methods comparison, the tumor is located right liver surgery time when there was a significant difference (p lt; 0.05), tumor diameter, intraoperative blood transfusion, postoperative hospital stay, postoperative 1 week alanine aminotransferase, albumin, total bilirubin, cholinesterase was no significant difference (P gt ; 0.05). Conclusion: in a different half of the liver with primary liver cancer in liver resection surgery and postoperative recovery there are differences: the tumor is located in the right liver, liver and hepatic inflow occlusion by semi surgical resection operation time and postoperative duration of hospitalization was prolonged; application of local vascular occlusion transfusion volume, right liver after liver total bilirubin levels above left; application first hepatic vascular occlusion, postoperative total bilirubin water products may there are differences. In fully prepared perioperative preparation, patients are generally in good condition in the case, according to the actual anatomy surgery, tumor choose the appropriate surgical approach, surgical resection is safe and different methods of vascular surgery and intraoperative blockade the impact of short-term recovery after no significant difference.

Primary liver tumor location on the impact of surgery and surgical clinical analysis methods

Abstract

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