肝細胞癌破裂の治療と成績 TREATMENT AND PROGNOSIS OF RUPTURED HEPATOCELLULAR CARCINOMA

この論文にアクセスする

この論文をさがす

著者

抄録

肝細胞癌自然破裂11例について治療法とその成績にっいて検討した. 11例中4例は出血性ショックで来院し, 9例に緊急transcatheter arterial embolization (TAE) を施行した. 6例はTAEにより止血可能であり, 4例には二期的に肝切除を行った. 1例は1年6月生存中, 3例は2年6月, 1年3月, 1年で死亡した. TAEにて止血出来なかった3例は緊急手術となり, 2例は止血術のみを施行したが,術後早期に肝不全で死亡した. 1例は肝切除を行い2年3月生存中である.肝細胞癌自然破裂は緊急を要する例が多く十分な肝機能の評価ができないため, TAEにてまず止血し,肝切除出来る症例は二期的に施行することが予後の改善に貢献すると思われた.

Prognoses of 11 patients treated for spontaneously ruptured hepatocellular carcinoma were studied. Four patients of them were in hemorrhagic shock state on admission, and nine patients underwent emergency transcatheter arterial embolisation (TAE). TAE was effective for six patients, and four of the six patients were performed second-stage hepatectomy. One of the four patients is alive for 1.5 years, 3 patients were alive for 2.5 years, 1.5 years and 1 year, respectively. Another three patients for whom TAE was ineffective underwent emergency operation. Two out of the three patients undergoing hemos-tatic suture for the ruptured lesion died of hepatic failure in an early stage agter the operation. Remaining one patient undergoing one-stage hepatectomy is alive as of 2 years and 3 months after the operation. In the treatment of patients with ruptured heparoma, we usually have no enough time to evaluate the liver function, because the disease itself demand an emergency treatment. So it is recommended first to perform emergency TAE for the ruptured hepatoma, and then hepatectomy is added for patients whose conditions permit the operation. This two-step approach may contribute to an improvement of the prognosis.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 56(10), 2047-2052, 1995-10-25

    Japan Surgical Association

参考文献:  10件中 1-10件 を表示

被引用文献:  6件中 1-6件 を表示

各種コード

  • NII論文ID(NAID)
    10008515982
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    03869776
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
ページトップへ