肝切除术后腹腔热灌注化疗治疗外生性破裂性肝癌的研究进展

doi:10.3969/j.issn.1009-976X.2021.04.022

摘要/Abstract

摘要： 肝癌破裂作为威胁患者生命的严重并发症之一,其具有起病突然、病情进展快及凶险等特点,可导致患者的早期病死率较高。对于破裂性肝癌患者,肝切除术能有效止血的同时兼顾肿瘤的一种有效措施,特别是外生性的破裂性肝癌可使癌细胞脱落引起腹腔内播散种植,往往导致肝切除术后的患者远期预后差的情况。腹腔热灌注化疗（HIPEC）可在术后早期有效清除或杀灭腹腔内残存的游离癌细胞和亚临床病灶,最大限度达到宏观和微观上的共同根治,可成为预防外生性破裂性肝癌术后腹腔转移的潜在疗法。随着医学水平的发展及HIPEC临床应用的技术规范化,各类腹腔恶性肿瘤术后预防性运用HIPEC可明显降低腹腔种植率,并在总体临床疗效方面的作用已较为明确。外生性破裂性肝癌的“肝切除术+HIPEC”治疗模式具有很好的应用前景,故本文对外生性破裂性肝癌术后辅助HIPEC的临床应用进展进行综述,以供临床参考。

关键词: 肝癌, 外生性, 破裂性, 肝切除术, 腹腔热灌注化疗

Abstract: As one of the serious complications threatening the life of patients, rupture of liver cancer has the characteristics of sudden onset, rapid progression and danger, which can lead to a high early mortality rate of patients. For patients with ruptured liver cancer, hepatectomy can effectively stop bleeding and take into account the tumor at the same time, especially exogenous ruptured liver cancer can cause cancer cells to fall off and cause intraperitoneal dissemination and implantation. It often leads to poor long-term prognosis of patients after hepatectomy. Hyperthermic intraperitoneal chemoperfusion （HIPEC） can effectively remove or kill the remaining free cancer cells and subclinical lesions in the abdominal cavity in the early stage after operation, and achieve a common radical cure in both macro and micro level. It can become a potential therapy for the prevention of postoperative abdominal metastasis of exogenous ruptured liver cancer. With the development of medical level and the standardization of clinical application of HIPEC, the prophylactic use of HIPEC after operation of all kinds of abdominal malignant tumors can significantly reduce the implantation rate of abdominal cavity and play a clear role in the overall clinical effect. The “hepatectomy+HIPEC” treatment mode of exogenous ruptured liver cancer has a good application prospect, so this article reviews the progress of clinical application of postoperative adjuvant HIPEC for exogenous ruptured liver cancer for clinical reference.

Key words: liver cancer, exogenous, rupture, hepatectomy, hyperthermic intraperitoneal chemoperfusion

中图分类号:

何泳铸, 钱均霖, 叶少炜, 刘立文, 何坤, 黄锐钦, 罗启杰, 彭鹏, 胡泽民. 肝切除术后腹腔热灌注化疗治疗外生性破裂性肝癌的研究进展[J]. 岭南现代临床外科, 2021, 21(04): 477-481.

HE YongZhu, QIAN Jun-lin, YE Shao-wei, LIU Li-wen, HE Kun, HUANG Rui-qin, LUO Qi-jie, PENG Peng, HU Ze-min. Research progress of hyperthermic intraperitoneal chemoperfusion in the treatment of exogenous ruptured hepatocellular carcinoma after hepatectomy[J]. Lingnan Modern Clinics In Surgery, 2021, 21(04): 477-481.

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