腹腔镜射频消融术治疗特殊部位肝癌23例  

Laparoscopic Radiofrequency Ablation for the Liver Cancer at Special Locations

作　　者：王江华[1] 陈先祥[1] 蔡庆和[1] 吴黎明[1] 刘小波[1] 涂华华[1] 马泽君[1] 周波[1] 

机构地区：[1]湖北医药学院附属人民医院肝胆外科,十堰442000

出　　处：《中国微创外科杂志》2013年第2期131-132,138,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜射频消融术(laparoscopic radiofrequency ablation,LRFA)治疗特殊部位肝癌的疗效。方法 2008年5月～2011年5月对23例特殊部位肝癌在全麻下行LRFA,其中原发性肝癌19例,转移性肝癌4例,单发肿瘤15例,多发8例,肿瘤直径(3.8±1.1)cm,热辐射损毁范围一般超过肿瘤直径0.5～1 cm。结果 23例均安全完成LRFA,单个病灶射频消融时间(9.2±4.3)min,手术时间(98.7±21.5)min,出血量(80.6±21.8)ml。术后未发生腹腔出血、胃肠道损伤、膈肌损伤及肝功能衰竭等并发症。术后1个月螺旋CT增强扫描证实,瘤体完全消融率达100%。术后1、2、3年生存率分别为91.3%(21/23)、80.9%(17/21)、76.4%(13/17)。6例术后复发,复发率26.1%(6/23),复发时间术后2～18个月(平均7.5月);10例死亡:3例死于肝功能衰竭,5例死于消化道出血,2例死于肿瘤复发转移。结论对于特殊部位肝癌LRFA是一种安全、创伤小的方法。] Objective To investigate the efficacy of laparoscopic radiofrequency ablation （LRFA） for patients with hepatocellular carcinomas （HCCs） at special sites. Methods Totally 23 patients with special-site HCCs received LRFA under general anesthesia in our hospital from May 2008 to May 2011. Among the patients, 19 were diagnosed with primary liver cancer and 4 with metastatic liver cancer; 15 of them had a single tumor, and the other 8 had multiple tumors. The mean diameter for radiofrequency was （3.8 ± 1.1） cm. Results LRFA was completed successfully in all the patients. The mean operation time was （9.2 ± 4.3） min per lesion, and （98.7 ± 21.5） min in total. The mean total blood loss was （80.6 ± 21.8） ml. No severe complications such as bleeding, gastrointestinal tract damage, diaphragmatic injury or liver function failure were developed after the operation. A complete tumor necrosis was achieved in all the patients, shown by contrast-enhanced helical CT scans in one month after the procedures. The 1-, 2-, and 3-year survival rate was 91.3% （21/23）, 80.9% （17/21）, and 76.4% （13/17）, respectively. Six （26.1%, 6/23） of the patients showed recurrent tumor in a mean of 7.5 months （ ranged from 2 to 18 months）. Ten of the patient died of liver function failure （3 cases）, gastrointestinal tract damage （5 cases）, or tumor metastasis （2 cases） during follow-up. Conclusion LRFA is a safe and minimally invasive for special-site liver cancer.

关 键 词：腹腔镜射频消融术 肝癌 腹腔镜超声 

分 类 号：R735.7[医药卫生—肿瘤]