摘要
目的比较射频消融术与腹腔镜肝切除术治疗原发性小肝癌的疗效。方法采用回顾性队列研究,纳入2018年11月至2020年10月在昆山市第一人民医院治疗的原发性小肝癌共129例,其中行经皮射频消融术43例(经皮射频组),同期行腹腔镜下射频消融术43例(腔镜射频组),行腹腔镜肝切除术43例(腔镜手术组)。比较3组患者围手术期指标、肝功能指标、并发症发生率、术后3年总体生存率和3年复发率。结果经皮射频组手术时间短于腔镜射频组和腔镜手术组,且腔镜射频组短于腔镜手术组(P<0.05);腔镜手术组术中出血量大于腔镜射频组和经皮射频组,住院时间长于腔镜射频组和经皮射频组(P<0.05);腔镜射频组与经皮射频组的术中出血量、手术时间比较,差异无统计学意义(P>0.05)。术后5 d血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素水平,腔镜手术组高于腔镜射频组和经皮射频组(P<0.05)。腔镜射频组的并发症发生率为6.98%,低于经皮射频组(23.26%)和腔镜手术组(32.56%)(P<0.05)。3组患者3年总体生存率比较,差异无统计学意义(P>0.05)。经皮射频组3年复发率高于腔镜射频组和腔镜手术组,且腔镜射频组高于腔镜手术组(P<0.05)。结论腹腔镜下射频消融术治疗原发性小肝癌的疗效与腹腔镜肝切除术接近,同时具有创伤小、恢复快、并发症少的优点。
Objective To compare the efficacy of radiofrequency ablation and laparoscopic liver resection for primary small hepatocellular carcinoma.Methods A retrospective cohort study was used.A total of 129 cases of primary small hepatocellular carcinoma treated at Kunshan First People's Hospital from November 2018 to October 2020 were selected,including 43 cases undergoing percutaneous radiofrequency ablation(Group A),43 cases undergoing laparoscopic radiofrequency ablation(Group B),and 43 cases undergoing laparoscopic liver resection(Group C)during the same period.It was compared of perioperative indicators,liver function indicators,incidence of complications,3-year overall survival rate,and 3-year recurrence rate among the three groups.Results Operation time of Group A was shorter than that of Group B and C(P<0.05).The intraoperative bleeding volume of Group C was the greatest,and the hospitalization stay was the longest(P<0.05).There was no statistically significant difference in intraoperative blood loss and surgical time between the two radiofrequency groups(P>0.05).Serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)on postoperative day 5 were significantly higher in Group C than the other two groups(P<0.05).The incidence of complications in Group B was 6.98%,which was lower than that in Group A(23.26%)and Group C(32.56%)(P<0.05).There was no significant difference in the 3-year overall survival rate among the three Groups(P>0.05).The 3-year recurrence rate of Group A was higher than that of Group B and Group C,while Group B was higher than the Group C(P<0.05).Conclusion The efficacy of laparoscopic radiofrequency ablation for the treatment of primary small hepatocellular carcinoma is similar to that of laparoscopic hepatectomy,and it has the advantages of minimal trauma,quick recovery,and few complications.
作者
夏晓华
龚伟
贾乃昕
XIA Xiaohua;GONG Wei;JIA Naixin(Department of Hepatobiliary Surgery,Kunshan First People's Hospital,Kunshan 215300,Jiangsu,China)
出处
《中国现代手术学杂志》
2025年第4期259-264,共6页
Chinese Journal of Modern Operative Surgery
关键词
肝肿瘤
小肝癌
射频消融术
肝切除术
腹腔镜检查
liver neoplasms
small hepatocellular carcinoma
radiofrequency ablation
hepatectomy
laparoscopy
