特殊部位肝癌的腹腔镜下射频消融治疗  

Laparoscopic radiofrequency ablation (LRFA) therapy for hepatocelluar carcinomas in particular location

作　　者：温子龙[1] 薛平[1] 卢海武[1] 郑强[1] 陈楷[1] 

机构地区：[1]广州医学院第二附属医院肝胆外科,510260

出　　处：《现代消化及介入诊疗》2012年第3期138-140,共3页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省科技计划项目(2010B031600141)

摘　　要：目的探讨腹腔镜下射频消融术(LRFA)在特殊部位肝癌治疗中的临床疗效和安全性。方法对2010年1月～2011年12月我院39例经螺旋CT证实的肝癌患者实施LRFA临床资料回顾分析。单病灶者25例,2个病灶者14例,共计53个病灶,分别位于肝脏表面、膈顶部、心包及毗邻胆囊、胃肠的肝肿瘤,肿瘤平均直径为3cm。结果 39例患者均顺利完成手术,单病灶LRFA平均时间为30min,平均总手术时间为45min。未出现腹腔出血,胃肠道损伤,膈肌损伤及肝功能衰竭等严重并发症。术后一个月螺旋CT增强扫描证实,病灶完全坏死率达100%。随访12～24个月,2例发现肝内新病灶,4例消融部位复发,采用TACE或再次腹腔镜下射频消融治疗。结论 LRFA安全性好、恢复快、疗效确切,已成为包括位于特殊部位肝癌微创治疗的主要手段。Objective To evaluate the safety and efficiency of laparoscopic radiofrequency ablation（LR- FA） therapy for patients with hepatoceUuar carcinomas（HCCs） in particular location. Method From January 2010 to December 2011, 39 patients with HCC in particular location were treated with LRFA. Among the pa- tients, 49 hepatic lesions with a mean diameter of 3 cm were identified preoperatively by helical CT. Single le- sion was found in 25 patients, two lesions were found in 14 patients. The hepatic lesions were located in the surface of the liver, adjacent to diaphragmatic dome, pericardium, gallbladder, or gastrointestinal tract. Result LRFA therapy was successfully performed in all patients. The mean LRFA time per lesion was 30 minutes, the mean total operation time was 45 minutes. No severe complications such as bleeding, gastrointestinal tract damage, diaphragmatic injury and liver function failure developed after operations. A complete tumor necrosis was achieved according to contrast enhanced helical CT scan in all patients one month after operations. During follow-up of 12-24 months, 2 patients had new malignant nodules and 4 patients recurred locally at the LRFA sites for whom TACE or LRFA was performed successfully. Conclusion LRFA is a feasible, safe, and effec- tive treatment modality for patients with HCC in particular location especially adjacent to diaphragmatic dome, pericardium, gallbladder, or gastrointestinal tract.

关 键 词：腹腔镜射频消融(LRFA) 肝细胞癌(HCC) 

分 类 号：R541.71[医药卫生—心血管疾病]