摘要
目的 探讨腹腔镜辅助射频消融术治疗特殊部位小肝癌的可行性、安全性及优势,并评估其疗效.方法 为65例合并不同程度肝硬化肝癌患者、79个特殊部位肿瘤行腹腔镜辅助射频消融术（laparoscopic radiofrequency ablation,LRFA）,肿瘤位于肝脏表面、近膈顶、肝门部、邻近胆囊、胃肠等空腔脏器,平均直径为2.162±0.6417 cm.结果 65例均成功施行LRFA治疗,单个病灶平均布针为3次,平均LRFA时间为39.2±7.0 min,所有病例均未出现大出血、胆漏、胃肠道烧灼、膈肌损伤、肝功能衰竭等严重并发症.术后住院4～11天,平均8.3d.术后一月复查,34例术前血清AFP阳性的患者均下降到正常范围、超声检查或螺旋CT增强扫描病灶完全坏死率达100％.随访1～24个月,3例发现肝内新病灶,复发时间为5～22个月,再次采用腹腔镜下射频消融治疗.结论 LRFA为特殊部位小肝癌患者提供了安全、有效、经济、微创的治疗方法,具有良好的临床应用价值.
Objective To explore the feasibility,security and advantage of laparoscopic radio frequency ablation （LRFA） for the small liver cancer of special parts and to evaluate the curative effect.Methods 65 patients who suffered liver cancer with 79 tumor nodules on special parts were treated by LRFA.The hepatic lesions with a mean diameter of 2.162 ±0.6417 cm were located in the surface of the liver,adjacent to diaphragmatic dome,fossae tis heransversalpatis,gallbladder,or gastrointestinal tract.Results LRFA therapy was successfully performed in all patients.The mean LRFA time per lesion was 39.2 ±7.0 minutes,the mean RFA times for a single nodule is 3.No severe complications such as bleeding,bile leakage,gastrointestinal tract damage,diaphragmatic injury and liver function failure developed after operations.Patients hospitalized 4-11 days,with an average of 8.3 days.Checked-up one month after the operation,AFP decreased to regular range in 34 patients and complete tumor necrosis was achieved in all the patients by CT or Ultrasound.During follow-up of 5-22 months,3 patients had new malignant nodules for whom LRFA was performed successfully again.Conclusions LRFA for special parts small liver cancer provides a safe,effective,economical,and minimally invasive treatment.
出处
《肝胆外科杂志》
2014年第1期20-24,共5页
Journal of Hepatobiliary Surgery
关键词
肝肿瘤
射频消融术
腹腔镜检查
Liver neoplasms
Radio frequency ablation, Laparoscopy州350025
