[Hepatocellular carcinoma. Our experience].
From June 1991 to february 1993, 29 patients with hepatocarcinoma in cirrhosis were admitted to our department. After a careful preoperative assay, 17 patients underwent hepatic resection. These patients were suffering from unifocal or superficial tumours with Child A or Child B hepatic function. In the other 12 patients, with multifocal hepatocarcinoma or with Child C hepatic function, a Port-a-cath was implanted in the hepatic artery for chemotherapy. The hepatic resection, performed after clampage of the hepatic hilum, was always restricted to exeresis of the tumor at 1 cm, of its border, avoiding damage to the poor hepatic function because of cirrhosis. The average time in performing such an important procedure was 20 minutes. There was no postoperative death and all patients still alive. Postoperative complications were ascites, always treated with diuretic therapy and albumin, and moderate pleuritis. Our good results depend on accurate preoperative assay and especially on the restricted hepatic resection that didn't reduce the hepatic functional reserve further. The implantation of a Port-a-cath in the hepatic artery, performed in patients not suitable for surgical procedures, allows us to carry ut the right chemotherapy in the other patients, eliminating the risk of postoperative deaths.
Catona
A
A
Divisione di Chirurgia, USSL n. 77, Pavia.
Armeni
E
E
Gossenberg
M
M
Martino
N E
NE
La Manna
L
L
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D002408:Catheters, Indwelling; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008099:Liver / Q000601:surgery; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged
D000970:Antineoplastic Agents
Il carcinoma epatocellulare. Nostra esperienza.