腹腔镜引导定位肝脏肿瘤射频消融治疗的临床观察  

Laparoscopic radio-frequency ablation in treatment of hepatic carcinoma

作　　者：宋希林[1] 石学涛[2] 宋金龙[3] 李彦良[1] 苏琴 李增军[1] 张波[2] 周武元[2] 

机构地区：[1]山东省肿瘤医院普外科,山东济南250117 [2]山东省肿瘤医院肝胆外科,山东济南250117 [3]山东省肿瘤医院介入科,山东济南250117 [4]新疆农二师库尔勒医院,新疆库尔勒841000

出　　处：《中华肿瘤防治杂志》2009年第13期1025-1027,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨腹腔镜直视引导定位下肝癌射频热凝消融治疗(radio-ferquency abla-tion,RFA)的可行性。方法:在腹腔镜直视引导定位下分别对10例原发性肝癌和多发转移性肝癌进行一次性射频消融治疗。结果:10例患者28个瘤体中直径<5 cm的20个肿瘤均获得一次性热凝损毁,其中18个瘤体完全缓解CR 90.0%(18/20),2个瘤体部分缓解PR 10.0%(2/20),近期疗效CR+PR为100.0%(20/20),1例术后15个月肝、肺转移复发;8个直径5～9 cm的瘤体近期疗效为CR+PR 100.0%(8/8),CR 50.0%(4/8),PR50.0%(4/8),1例术后6个月发生肝门部转移及阻塞性黄疸而病情进展死亡,1例术后14个月因肝脏、肺脏广泛转移死亡。术后2周复查AFP、CEA和CA19-9等肿瘤标志均有不同程度的下降或转阴。所有患者均很好地耐受了射频消融治疗,无严重并发症出现。9例患者术后分别行1～4次肝动脉化疗栓塞介入治疗(TACE)。1年生存率为85.7%(6/7),2年生存率为50.0%(3/6)。结论:腹腔镜直视引导定位下肝癌射频消融治疗为不能手术的原发性肝癌及多发性肝转移癌提供了一种微创、安全、有效、方便的治疗方法,与TACE结合效果更佳。OBJECTIVE： To explore the potential efficacy and feasibility of laparoscopic radio-frequency ablation （LRFA） in the treatment of hepatic carcinoma. METHODS： Laparoscopic radio-frequency ablation was used for 10 cases of primary hepatocellular carcinoma and hepatic metastasis. RESULTS： Among the 10 patients with 28 hepatic cancer lesions, 20 lesions with diameter 〈5 cm were demaged by one time of radio-frequency ablation, and among them 18 lesions （90.0%） were CR and 2 lesions （10.0%） were PR. The effective rate was 100.0% （CR＋PR）. One patient has hepatic and lung metastasis after operation 15 months. The respone rate of 8 lesions with diameter 5-9 cm was 100.0% （CR 50.0% and PR 50.0%）. One patient with hepatic door metastasis and obstructive jaundice died 6 months postoperation. One patient died due to hepatic and lung metastasis 14 months postoperation. The tumor makers such as AFP, CEA and CA19-9 also became negative or fall down 2 weeks after the treatment. There were no any complications occurred after the radio-frequency ablation. Nine patients also received 1-4 times of transhepatic artery chemoembolization （TACE） treatment. the 1 ,2-year survival rates were 85.7% and 50.0%,respeetively. CONCLUSIONS： Laparoscopie radio-frequency ablation is a feasible, effective, safe and minimally invasive method in the treatment of primary hepatocellular carcinoma and hepatic metastasis which can＇t be operated. The curative effect is better while LRFA combines with TACE.

关 键 词：肝肿瘤/治疗 导管消融术 腹腔镜检查 可行性研究 

分 类 号：R735.7[医药卫生—肿瘤]