| ObjectiveTo explore using precise hepatectomy(Precision liver resection) clinical curative effect for the treatment of primary liver cancer.Methods Using retrospective analysis in ningxia medical university general hospital between January 2013 and September 2013 were 145 routine liver resection of primary hepatocellular carcinoma(HCC) patients as the research object, with 112 cases male patients, 33 patients with female, the age of 21-73 years old, average age(45.7-1.5).All 48 patients with normal liver resection patients with boc, precise, 97 cases of patients with hepatic resection.Regular hepatectomy group of 35 patients with male, 13 cases of female patients, aged 23-69, the average age(44.1-1.9).Accurate male patients, 72 cases of liver resection group, 25 patients with female, age of 21-73 years old, average age(45.7 + 1.5);5 cases were primary tumors, including lung cancer, breast cancer, 3 cases, 3 cases of thyroid cancer, prostate cancer, 2 kidney in 2 cases, 3 cases of other parts of the tumor;Transfer of vertebral lesion distribution: thoracic 16, lumbar 8;Are the osseous lesions.Patients have lower back pain, spinal cord compression symptoms.The clinical manifestations of 145 patients, 103 patients with liver area pain symptoms, 45 patients can obviously reach the upper right abdomen bag piece, no obvious clinical manifestations of 17 cases, for medical discovery.When all of the patients, the hospital liver Child- Pugh rating to A level of 122 cases, class B(19 cases), but the positive intervention both in preoperative reached A level.Imaging examination, ultrasound, CT and MRI examination method to confirm a solid liver space-occupying lesions, the average diameter was(10.1 + 3.1) cm, single-shot 102 cases, multiple 43 cases.Operation method: 82 cases with right half liver resection, 48 cases of left liver resection of liver resection in 1 case.Record and compare the two groups of patients with surgery time and blood loss, postoperative all patients were detected and compared serum albumin(propagated), alanine aminotransferase(ALT) and total bilirubin(TBIL) level.Record and compare the two groups of patients with postoperative complications, including abdominal bleeding, bile leak, lung infection, and pleural effusion.Follow-up of 1 year, compare two groups of patients with difference of recurrence rate and survival rate.The inadequacy 0 statistical methods: using SPSS statistical software for statistical analysis of measurement data to mean + /- standard deviation(x + s) said, using T test, using x2 test for count data, to P < 0. 05 for the difference was statistically significant.Results Only one case(5.6%) had skin burns, all patients without spinal cord, nerve root injury and bone cement leakage. technical success rate is 100%. Pathologic examination before RFA showed that all specimen were bone metastases carcinoma, and no necrosis of tumor cells. Pathologic examination after RFA showed that all bone tumor cells were been necrosis. All cases got completely follow-up 3 months and with an average follow-up 5.2 months. The postoperative pain of all cases relieved apparently within 24 h, Postoperative following 3 months pain relief completely 9 cases(50.0%), 7 cases(38.9%)of medication requirements decreased or painkillers level is reduced, maintain the original amount in 2 case(11.1%) and no one with painkiller's level upgraded. The VAS, JOA, RDS and vertebral body height preoperational is 8.2, 19.2, 21.3, 2.3cm, 2.6cm, the postoperation is 1.9, 26.5, 5.5, 2.6cm, 2.8cm. The changes between preoperation and postoperation are all statistically significant(P<0.05).It showed that the back pain, dysfunction, vertebral body height were improved significantly after the treatment.Conclusions: Precision compared with the conventional liver resection, liver resection of primary liver cancer curative effect is good, but at the same time reduce the incidence of complications in the effective elimination of lesions, help patients with postoperative recovery. |
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