Resection of hepatocellular carcinoma after transcatheter arterial embolization. Reevaluation of the advantages and disadvantages of preoperative embolization.
Resection of hepatocellular carcinoma after transcatheter arterial embolization. Reevaluation of the advantages and disadvantages of preoperative embolization.
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经导管动脉栓塞术后肝细胞癌切除。
DOI：
10.1001/archsurg.1987.01400190022004
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发表时间：
1987
影响因子：
--
通讯作者：
Y. Liaw
中科院分区：
文献类型：
--
作者：
T. Hwang;M. F. Chen;T. Lee;T. J. Chen;D. Lin;Y. Liaw
8例术前经导管动脉栓塞（TAE）患者和25例术前未行TAE的患者均切除了肝细胞癌（HCC）。前一组中有3例患者在手术前已经破裂。随访1年半，前者2例，后者3例复发。尽管术前TAE导致肿瘤坏死显著增加，但它增加了胆囊坏疽性变化的风险，诱导了肝十二指肠韧带粘连，并且如果选择用于TAE的血管不足，则不能有效减少手术失血量或手术时间。病理检查发现肝内静脉内仍有肿瘤栓子存在。TAE不影响肿瘤细胞的子结节和包膜浸润。经导管动脉栓塞似乎是有效的控制出血的肝癌破裂前分期切除肿瘤。
Hepatocellular carcinomas (HCCs) were resected in eight patients who had preoperative transcatheter arterial embolization (TAE) and in 25 patients without preoperative TAE. Three patients in the former group had ruptured HCCs before operation. Two of the former group and three of the latter group were found to have recurrences after a follow-up of 1 1/2 years. Although preoperative TAE resulted in significantly increased tumor necrosis, it increased the risk of gangrenous change of the gallbladder, induced adhesion of the hepatoduodenal ligament, and was not effective in reducing operative blood loss or operative time if the vessel selected for TAE was inadequate. Pathologic examination revealed tumor emboli still existing in the intrahepatic veins. Daughter nodules and capsular invasion by tumor cells were not affected by TAE. Transcatheter arterial embolization seems to be effective in controlling bleeding from ruptured HCC prior to staged resection of the tumor.