96 KB21 KB192920262003Gadžijev, EldarSojar, ValentinStr. I-49 - I-52COBISSID_HOST:1247807URN:URN:NBN:SI:doc-L7DN34ECslSlovensko zdravniško društvoZdravniški vestnikCarcinoma, hepatocellularDiagnostic techniques and proceduresDiagnostične metode in postopkiJetraJetra, novotvorbeKirurški postopki, operativniLiverLiver neoplasmsRak, hepatoceličniSurgical procedures, operativeRak jeter| Liver cancer|Background. Liver cancer is the most frequent malignant tumor of the solid organs in the world, but it is relatively rare in Slovenia. Because of the hepatitis C spreading we can expect a considerable rise of hepatocellular carcinoma also in Slovenia. For diagnosis angiography with Lipiodol and CT scan after 10 days is a useful method. AFP is elevated only in 60% of patients. The stage of liver disease is crucial for the treatment. The only possibility to cure these tumors is surgical removed when possible with segment oriented liver resection. For small HCC in decompesated cirrhosis liver transplantation is the treatment of choice. Good results in small tumors in advanced cirrhosis have been reported also using ablation methods or intersticial therapy. Recurrence is frequent and repeated surgical treatment is possible in about 50% of the patients. Patients and methods. A two years review of surgical treatment of liver tumors in Slovenia is presented. We included patients with HCC and cholangiocarcinoma (parenchymal and hillar). There was 21 patients with HCC and 23 patients with cholangiocarcinoma treated in two centers (Ljubljana and Maribor). Chronic liver disease was found in only 30% of patients with HCC. Liver resection was performed in 35 patients; hepatectomy in 5 patients and segmental resection or wedge resection in 30 patients. There was 30% morbidity and 2.2% mortality in this group of patients. Conclusions. We can conclude that only a small part of patients with HCC in Slovenia are being treated surgically, although our results of surgery are comparable with those from other specialized surgical institutions abroadIzhodišča. Rak jeter je najpogostejši rak solidnih organov na svetu, pri nas pa je sorazmerno redek. V bodoče v Sloveniji pričakujemo pomemben porast pojavljanja hepatoceličnega raka jeter zaradi širjenja hepatitisa C. Jetrno cirozo štejemo za prekancerozo. Za diagnozo je pomembna angiografija z lipiodolom in po 10 dnevih napravljena preiskava s CT. Tumorski označevalec AFP je povišan le v 60%. Pomembno in odločujoče za zdravljenje je stanje osnovne jetrne bolezni. Kirurško operativno zdravljenje predstavlja resekcija jeter, ki je osnovana na jetrnih segmentih. V primerih napredovale jetrne ciroze z majhnim hepatitienim rakom (HCC) je uspešno zdravljenje s presaditvijo jeter. Dobre rezultate pri majhnih tumorjih lahko dosežemo s t. i. interstijciskim zdravljenjem. Ponovitve bolezni so pogoste in dodatno kirurško zdravljenje je možno v 50%. Bolniki in zdravljenje. Prikazujemo kratko analizo bolnikov, ki smo jih zdravili zaradi raka jeter v dveh kirurš kih ustanovah v letih 2000 in 2001. V prikaz smo zajeli poleg bolnikov s HCC tudi vse bolnike s holangiokarcinomom (tkivnim in hilusnim). Bolnikov s HCC je bilo 21 in s holangiokarcinomom 23. Kronično jetrno bolezen smo našli le v 30% bolnikov s HCC. Operirali smo skupaj 35 bolnikov, v petih primerih smo napravili veliko jetrno resekcijo, pri 30 bolnikih pa segmentno orientirano resekcijo jeter, usmerjeno po segmentih. Smrtnost je bila 2,2% in obolevnost 30%. Zaključki. Na osnovi izsledkov analiziranih primerov ugotavljamo, da operiramo v Sloveniji le manjši del bolnikov, obolelih za HCC, da pa imamo pri operativnem zdravljenju primerljive rezultate z ustanovami v tujiniTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo