What should I pay attention to after liver cancer resection? Why does liver cancer recur after resection?

Postoperative care for liver cancer is very important. Ensuring that patients and their families have a proper diet and rest can help reduce the occurrence of complications and control the progression of the disease.

1. Closely monitor vital signs

After surgery, patients should return to the ward and lie flat without a pillow for those who are not awake after general anesthesia. They should receive oxygen, suction sputum, ECG monitoring, and properly fix various drainage tubes and gastric tubes to ensure effective drainage or suction of each drainage tube. Observation for bleeding should be strengthened, and attention should be paid to whether the patient has early symptoms of jaundice and hepatic coma.

2. Posture and activity

Rest in bed within 24 hours after surgery and avoid severe coughing to avoid postoperative bleeding. If the patient's blood pressure is stable, he or she can be placed in a semi-recumbent position. In order to prevent postoperative bleeding on the liver section, it is generally not advisable to move too early. Encourage patients to move in bed, observe the nature and duration of the patient's incision pain, and give analgesics as prescribed by the doctor.

3. Diet and Nutrition

Postoperative fasting, gastrointestinal decompression and infusion support as prescribed by the doctor. After intestinal function is restored, liquid juice, semi-liquid juice, and normal diet are gradually given. Patients with ascites limit salt intake, eat small meals frequently, and supplement albumin and plasma in appropriate amounts within 2 weeks after surgery to improve the body's resistance. Observe and record changes in body weight and abdominal circumference every day. Continue to take effective liver protection measures: oxygen inhalation for 2 to 4 days, supplement protein, plasma, branched-chain amino acids, etc. to increase the liver's oxygen supply, protect liver function, and promote the regeneration and recovery of liver cells.

4. Care of the drainage tube

After hepatectomy, there is a small amount of exudation from the liver section and surgical wound. Double cannulas are often placed. The drainage tube should be properly cared for and fixed, and the amount, properties and patency should be closely observed. Generally, 100 to 300 ml of bloody fluid can be drained from the parahepatic drainage tube on the day of surgery. If the amount of bloody fluid increases, intracavitary hemorrhage should be alert. If the patient's blood pressure and pulse are still unstable after blood transfusion and infusion, preparations for another surgery should be made.

5. Prevent infection

Take good care of your oral cavity, scrub your perineum, and change your drainage bag every day. If there is exudation from the incision, notify your doctor in time to change the dressing. Use antibiotics reasonably and effectively as directed.

What else should we pay attention to after liver cancer resection?

Patients should establish an optimistic spirit, strengthen their confidence in overcoming the disease, and live a positive life. Liver cancer is a serious disease, but it is by no means incurable, and it can even be cured. There are liver cancer patients both at home and abroad who have survived for more than 20 years after surgical treatment. Close cooperation with medical staff is required to fight against liver cancer tenaciously. In terms of diet and daily life, attention should be paid to rest. If physical strength allows, appropriate activities can also be done, but not to the extent of feeling tired. Eat more protein-rich foods and fresh vegetables and fruits. Unless it is necessary for treatment, patients do not need to avoid certain foods, so as not to cause malnutrition, which is not conducive to treatment. Food should be light and easy to digest, and avoid eating moldy, pickled, smoked and roasted foods.

Of course, 2-4 weeks after liver cancer resection, patients should actively adopt supportive therapy combining traditional Chinese and Western medicine to promote early recovery. Then, chemotherapy, radiotherapy or immunotherapy, as well as traditional Chinese medicine and Chinese herbal medicine, etc., should be carried out according to the specific conditions of the patient. If the patient has no liver cirrhosis, the tumor is small and has a capsule, the tumor has not invaded the blood vessels, and the malignancy of the cancer cells is very low, then after radical resection, chemotherapy or radiotherapy may not be performed, but appropriate adjuvant Chinese medicine or immunotherapy is still necessary. These can be carried out under the guidance of a specialist. However, we must also realize that the effectiveness of various treatment methods depends on many factors, among which the patient's liver function status plays a big role. Therefore, actively carrying out liver protection treatment and avoiding various factors that aggravate liver damage are essential contents in the comprehensive treatment of liver cancer.

Beware of relapse

Patients should be alert to the recurrence of liver cancer. This is the most important thing that should be paid attention to. Why does liver cancer recur after resection? It is currently believed to be related to the following factors:

① There are smaller cancer foci in the liver, which were not discovered when the main tumor was removed, and the residual cancer cells continue to grow after the operation.

② Due to the high malignancy of liver cancer cells, the rapid growth of cancerous tissues, and the rich blood supply of the liver, cancer cells can easily invade the liver blood vessels and metastasize to other parts of the liver through the blood flow. During surgical resection, rough operation and excessive squeezing can also cause cancer cells to enter the blood vessels and metastasize.

③ When cirrhosis occurs, other parts of the liver that have become cancerous may also become cancerous at the same time or at different times.

④ New tumors on the liver. In order to detect and treat recurrent liver cancer in time, we require patients to go to the hospital for regular checkups after liver cancer resection. Generally, they need to be checked every 2-3 months within 1-2 years after surgery, every 3-6 months within 3 years, and every six months for more than 3 years. Regular checkups are required for at least 5 years.

The review mainly includes alpha-fetoprotein (AEp) and B-ultrasound. The full name of AEp is alpha-fetoprotein. There are three types of globulins: A, B, and C. The so-called alpha-fetoprotein refers to the alpha-globulin present in the fetus. It is normal for the fetus in the mother to have alpha-fetoprotein. After the fetus is born, this alpha-fetoprotein gradually disappears, and it is no longer detectable or only a trace amount is detected in children around 1 year old. In liver cancer patients, liver cancer cells will produce alpha-fetoprotein again, and it can be detected in the blood. Generally, after surgical resection of liver cancer, the AEp in the patient's blood will drop, and some can drop to normal. Once liver cancer recurs, the alpha-fetoprotein level in the blood will rise again. Therefore, regular testing of AEp in the blood is helpful for the early diagnosis of recurrent liver cancer. B-ultrasound examination is low-cost, harmless to the human body, non-invasive, and can be repeated. It can generally detect tumor lesions with a diameter of about 2 cm. 80-90% of liver cancer cases can be diagnosed by B-ultrasound examination alone. Generally speaking, it is very helpful to improve the accuracy of diagnosis when the surgeon and the ultrasound doctor jointly perform B-ultrasound examination. If necessary, enhanced CT examination or selective hepatic artery angiography can be further performed to help clarify the diagnosis. Enhanced CT examination has a high accuracy in diagnosing liver cancer recurrence, but tumors with smaller diameters are easily missed. Selective hepatic artery angiography is the most reliable means to diagnose liver cancer recurrence. It injects contrast agent into a catheter inserted into the hepatic artery to visualize the recurrent liver cancer. The smallest cancer lesion that can be diagnosed is 0.3 cm in diameter. It can also show the location, type and portal vein of the tumor. Therefore, for those suspected of recurrence, it is best to do angiography if conditions permit. The disadvantage is that the patient has to be exposed to X-rays, which is painful and expensive.