肝癌切除术中氩气刀处理残肝断面对术后肿瘤局部复发的影响  

Effect of argon plasma coagulation treatment on local recurrence of tumor after hepatic resection

作　　者：沈裕厚[1] 谢振斌[1] 岳爱民[1] 魏齐栋[1] 尹宏达[1] 黄亮[2] 严以群[2] 

机构地区：[1]新乡市中心医院肿瘤外科,河南新乡453000 [2]第二军医大学附属东方肝胆外科医院肝外一科,上海200438

出　　处：《中华肿瘤防治杂志》2016年第8期525-529,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的肝癌术后复发和转移是制约肝癌手术疗效的重要因素,如何有效地预防和治疗肝癌术后复发转移是目前研究的重点和难点。本研究旨在探讨肝癌手术中应用氩气刀处理残肝断面对患者术后肿瘤局部复发和生存率的影响。方法回顾性分析329例第二军医大学附属东方肝胆外科医院2010-01-01-2013-01-31不能根治性切除肝癌手术患者,分氩气刀组和传统电刀组,对两组患者术后肿瘤局部复发时间和总生存率进行比较。结果氩气刀组术后3个月、6个月、9个月、1年和2年复发率分别为24.3%、37.8%、69.3%、82.1%和90.8%,传统电刀组分别为30.8%、58.3%、78.4%、89.1%和96.7%,两组中位复发时间分别为(6±1.7)和(4±1.3)个月。传统电刀组局部复发率明显高于氩气刀组,复发时间明显缩短,差异有统计学意义,χ2=11.705,P=0.001。氩气刀组患者术后6个月、1年、2年和3年总生存率分别为91.6%、60.4%、23.3%和10.1%,传统电刀组分别为80.1%、45.8%、12.5%和7.1%,两组中位生存期分别为(16±5.2)和(10±6.5)个月,氩气刀组总生存率明显高于传统电刀组,中位生存期明显延长,差异有统计学意义,χ2=8.746,P=0.003。结论肝癌术中应用氩气刀处理残肝断面可杀灭创面残留肿瘤细胞,减少肿瘤复发,在降低术后肿瘤局部复发率、提高患者总生存率以及延长生存时间等方面有积极的临床意义,值得临床推广。OBJECTIVE The recurrence and metastasis indicate poor prognosis of hepatocellular carcinoma after hepatectomy,how to effectively prevent and treat recurrence and metastasis after hepatectomy become an important and tough problem on current study.This study was designed to investigate the effectiveness in tumor local recurrence and survival rate after residue liver embedding was treated by argon plasma coagulation on patients with hepatocellular carcinoma.METHODS A retrospective analysis of 329non-radical resection of hepatocellular carcinoma patients,who were collected from January 1,2010 to January 31,2013 of Eastern Hepatobiliary Surgery Hospital Affiliated to the Second Military Medical University.and these patients were divided into intraoperative argon plasma coagulation group and traditional electric knife group.Local tumor recurrence and overall survival rates of the two groups were compared.RESULTS The recurrence rates of 3-,6-,9-month,1-,2-year in argon plasma coagulation group and the traditional electric knife group were 24.3%,37.8%,69.3%,82.1%,90.8%and 30.8%,58.3%,78.4%,89.1%,96.7%,the median time of recurrence was（6±1.7）months and（4±1.3）months.The local recurrence rate in electrotome group was obviously higher than that of argon plasma coagulation group（χ2=11.705,P=0.001）,and the recurrence time was evidently shorter.This result had statistic significance.The 1/2-,1-,2-,3-year overall survival rates of argon plasma coagulation group and the traditional electric knife group were 91.6%,60.4%,23.3%10.1%and 80.1%,45.8%,12.5%,7.1%.The median survival time were（16±5.2）months and（10±6.5）months,respectively.Compared with the traditional electric knife group,the overall survival rate of argon plasma coagulation group was much higher（χ2=8.746,P=0.003）, and the median survival period extended obviously. The statistical difference was significant.CONCLUSION The intraoperative application of argon plasma coagulation can kill residual tumor cells,reduce the tumor recurrence rates and

关 键 词：肝细胞癌 肝切除术 氩气刀 局部复发 总生存率 

分 类 号：R735.7[医药卫生—肿瘤]