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Objective To compare superiorities of liver malignant tumors underwent regular and irregular hepatectomies through approaching perioperative factors.Methods 1019 consecutive hepatectomies of liver malignant tumor from 1986 to 2009 at Air Force General Hospital and General Hospital of Chinese PLA were investigated retrospectively according to their medical documentation.Results Multivariate analysis showed that liver malignant tumors on which regular hepatectomy and irregular hepatectomy were performed,there was no significant difference in the blood loss,complications,mortality related to operation,hospital stay,and so on.But the operating time of regular hepatectomy was obvious more than that of irregular hepatectomy (P＜ 0.001,OR=1.004).Conclusions Although for liver malignant tumor,regular hepatectomy seems to be superior to irregular hepatectomy based on oncological theory,in clinical practice,there were no significant difference between the perioperative risk of regular hepatectomy and that of irregular hepatectomy.
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Objective To study the value of microwave coagulation therapy for liver malignant tumors.Methods Under local anesthesia,19 cases with hepatic malignant tumors treated with microwave knife under CT-guided.Results There were totally 23 tumors in 19 cases,13 tumors with≤3.5 cm in diameters were destroyed absolutely after the first treatmet,10 tumors among them were followed-up for 6-12 months and no recurred.10 tumors with＞3.5 cm in diameters treated at multiple points or angle,3～6 months later,CT showed that the tumors were destroyed completely in 6 and mostly in 4,by the hot condensate treatment secondly,3 tumors of 4 were destroyed completely 3 months later.There were no obvious complications.Conclusion The therapeutic effect under CT-guided microwave coagulation therapy for liver tumor which are ≤3.5 cm in diameter of the tumors is very reliable,the tumors＞3.5 cm in diameter can be destroyed mostly or completely by microwave treatment.
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Objective To explore curative effect of intraperitoneal chemotherapy to treat patients with tension ascites caused by advanced stage of liver cancer. Methods 61 patients with tension ascites caused by advanced stage of liver cancer were divided randomly into three groups, patients in group A (n=26) were treated by ultrafiltration ascites and peritoneal reinfusion (A-P) combined with intraperitoneal chemotherapy; patients in B group (n=18) were treated by paracentesis and intravenous albumin infusion combined with intraperitoneal chemotherapy; patients in group C (n=17) were treated by paracentesis and intravenous albumin infusion. Clinical situation, biochemical alteration, sodium metabolism and RAAS metabolism were observed before and after treatment.Results The findings revealed that definite clinical amelioration in all patients. Patients in three groups, biochemical examinations were improved during 24h after treatment, including of endogenous creatinine clearance rate and urine sodium output. But in group B and C, the biochemical examinations returned to the former levels and the levels of serum albumin was markedly reduced during 72h after treatment. The short-term effective rate on postoperative ascites in group A, B, C were 57.7%, 44.4% and 11.9% respectively.Conclusion A-P associated with intraperitoneal chemotherapy is an effective and safe therapy for patients with tension ascites caused by advanced stage of liver cancer.