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RESECTION OF METASTATIC HEPATOMA OF THE THORAX OR NEAR-DIAPHRAGM
胸腔轉移或橫膈膜相關肝癌切除術
摘要
A total of 25 patients with metastatic hepatoma of the thorax (extrahepatic metastasis) or near-diaphragm (intrahepatic metastasis) were surgically treated using thoracic resection over a period of almost 7 years. The patients were initially treated using various modalities before thoracic resections. The interval between first diagnosis of hepatoma and thoracic resection was 36±7 months. The metastatic lesions were usually located in on the right side. Operative procedures consisted of lung resection only (n=11), chest wall resection only (n=5), chest wall resection combined with lung resection (n=3), chest wall resection combined with diaphragm and liver resection (n=1), liver resection only (n=3), liver resection combined with diaphragm resection (n=1), and liver resection combined with lung resection (n=1). A total of 45 resections were performed. Two of these patients underwent repeated thoracic resections due to recurrences. There were no operative deaths, but one patient who had preoperative massive hemoptysis resulting in respiratory failure, required almost 4 weeks of ventilator support. In this series, the survival time was 63.6 ± 9.2 months after first diagnosis of HCC, and 25.2 ± 7.4 months after thoracic resection.
並列摘要
近7 年的時間內，共有25例肝癌轉移至胸部或病灶侵犯橫膈膜或緊鄰橫膈膜的肝癌病人，經胸腔切除手術治療。這些肝癌病人在經胸腔切除術前，曾經接受過不同的方式治療。初始肝癌診斷與經胸腔切除術，平均相隔36個月。這些病變通常位於身體的右側。手術方法如下；肺切除術（11位病人），胸壁切除術（5位病人），胸壁切除術合併肺切除術（3位病人），胸壁切除術合併隔膜及肝切除（1位病人），肝切除合併隔膜或肺切除（5位病人）。這25位病人共有45部位之切除，其中一位病人因復發共接受三次切除手術，另外一位病人因復發共接受兩次切除手術。沒有手術死亡，但有一位病人術前大量咯血，因呼吸衰竭，手術後需要4週的呼吸器支持。在這系列病人，經胸腔切除病灶後，平均存活時間為25.2個月。
延伸閱讀
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