摘要
目的:总结腹腔镜解剖性肝切除治疗食管癌术后孤立性肝转移的临床效果及优势。方法:回顾性分析2023年2月在南京大学医学院附属鼓楼医院肝胆外科收治的1例食管癌根治术后5月出现孤立性肝转移患者的病历资料，该患者经多西紫杉醇、顺铂及5-氟尿嘧啶(DCF方案)联合化疗4个周期，化疗期间出现右肝病灶，并逐渐增大，排除手术禁忌后行腹腔镜下解剖性肝右后叶切除。结果:患者顺利接受腹腔镜下解剖性肝右后叶切除治疗，术中出血少，术后无腹腔感染、出血、胆瘘等并发症，恢复顺利，术后病理结果符合食管癌肝转移。术后6月随访，患者恢复良好，术后在当地医院继续系统化疗3个周期，无复发、无进展。结论:食管癌术后孤立性肝转移经腹腔镜微创切除的局部手段，联合全身系统化疗，能够改善患者预后，提高生存率，延长生存期。
Abstract
Objective:To summarize the clinical efficacy and advantages of laparoscopic hepatectomy for solitary liver metastases after radical esophageal cancer resection.Methods:A retrospective analysis was performed for a patient with isolated liver metastases in the Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, in Feb. 2023. Whose right liver lesion was slowly enlarged during 4 cycles of chemotherapy by DCF (docetaxel, cisplatin and 5-fluorouracil) regimen, and then the anatomical laparoscopic right posterior lobectomy were performed.Results:The patient successfully underwent laparoscopic anatomical right posterior lobe resection of the liver, with less intraoperative bleeding, no postoperative complications such as infection, bleeding, and biliary fistula, and recovered smoothly. The postoperative pathological examination was consistent with the liver metastasis of esophageal cancer. The patient recovered well 6 months after surgery, no recurrence or progression, and continued systematic chemotherapy in the local hospital for 3 cycles.Conclusion:The laparoscopic minimally invasive resection of solitary liver metastases after oesophageal cancer resection, combined with systemic chemotherapy, improves prognosis and progression-free survival.
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