摘要
目的探讨肝切除术（右半肝、扩大半肝切除术）前应用门静脉栓塞（portal veine mbolization，PVE）的临床价值。方法通过电子检索Pubmed、Medline、Ovid数据库，对1986至2008年有关右半肝或扩大半肝切除术前行PVE的病例对照研究资料进行meta分析。结果共纳入文献9篇，494例患者。荟萃分析结果显示，PVE手术组较单纯手术组术后肝功能衰竭的发生率降低（P=0．02），但两者术后手术死亡的差异无统计学意义（P〉0．05）；亚组分析肝细胞癌和结直肠癌肝转移PVE手术组较单纯手术组1、3、5年生存率差异无统计学意义（P〉0．05）；1篇文献报道结肠癌肝转移发生率PVE手术组术后肝内复发转移发生较单纯手术组降低（P=0．001），而其他远处转移发生率相对增高（P=0．004）。结论术前行PVE能够有效降低术后肝功能衰竭的发生，但临床医师应当谨慎把握行术前PVE的指征。
Objective To investigate the clinical value of preoperative portal vein embolization （PVE） for extended hepateetomy. Methods A comprehensive Pubmed,Medline and Ovid database search to identify all registered literature on portal vein embolization. Meta-analysis was performed to assess the result of PVE. Results A total of 9 literatures provided data sufficiently enough for analysis involving in 494 patients. The results showed that postoperative liver failure was higher in the non-PVE group than the PVE group,but there was no difference in postoperative mortality between the PVE and non-PVE group;in subcategory analysis of hepatocellular carcinoma and liver metastasis of colorectal cancer, there was no difference in postoperative 1,3 and 5-year survival rate between the PVE group and non-PVE group;1 literature about liver metastasis of colorectal cancer show there was significant difference in postoperative metastasis between the PVE and non-PVE group; several patients after PVE weren＇t performed hepatectomy due to disease progress. Conclusions PVE is a safe and effective procedure to prevent postresection liver failure due to insufficient liver remnant, but surgeon should be cautious to choose the patient for PVE.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2008年第19期1460-1464,共5页
Chinese Journal of Surgery
