Objective: The aim of this study was to compare the therapeutic efficacy of radiofrequency ablation (RFA) and surgical resection for the patients with hepatocellular carcinoma (HCC). Methods: From January 2002 to June...Objective: The aim of this study was to compare the therapeutic efficacy of radiofrequency ablation (RFA) and surgical resection for the patients with hepatocellular carcinoma (HCC). Methods: From January 2002 to June 2009, 87 HCC patients with 3 or fewer nodules, no more than 3 cm in diameter, and liver function of Child-Pugh class A or B were enrolled. Forty-seven underwent RFA while 40 underwent surgical resection. Follow-up ranged from 6 to 69 months. We compared the overall and disease-free survival rate, recurrence patterns, and the complications between the two groups. Survival prob-abilities were estimated using the Kaplan-Meier method. Results: At the end of the study, 67 patients were alive. The 1-, 2- and 3-year overall cumulative survival rates after RFA and surgical resection were 91.0%, 76.7%, 69.7% and 90.0%, 82.9%, 75.4%, respectively. The difference between the two survival curves was not statistically significant (χ2 = 0.99, P = 0.32). Forty-three patients suffered intrahepatic recurrence, including 25 cases after RFA and 18 cases after surgical resection. The 1-, 2-, and 3-year disease-free survival rates after radiofrequency ablation and surgical resection were 57.3% vs 71.1%, 40.3% vs 45.7%, and 35.3% vs 30.9%. The difference between the two groups was not statistically significant (χ2 = 0.06, P = 0.80). Cox hazard model indicated tumor size and Child-Pugh scoring were significant risk factors for local tumor progression, while tumor numbers was risk factor for intrahepatic distant recurrence. Conclusion: RFA is as effective as surgical resection for the treatment of patients with HCC (≤ 5 cm), especially for those who are not suitable for curative resection.展开更多
Liver resections are demanding operations which can have life threatening complications although they are performed by experienced liver surgeons. Recently new technologies are applied in the field of liver surgery, h...Liver resections are demanding operations which can have life threatening complications although they are performed by experienced liver surgeons. Recently new technologies are applied in the field of liver surgery, having one goal: safer and easier liver operations. The aim of this article is to address the issue of bloodless liver resection using radiofrequency energy. Radionics, Cool-tipTM System and Tissue Link are some of the devices which are using radiofrequency energy. All information included in this article, refers to these devices in which we have personal experience in our unit of liver surgery. These devices take advantage of its unique combination of radiofrequency current and internal electrode cooling to perform sealing of the small vessels and biliary radicals. Dissection is also feasible with the cool-tip probe. For the purposes of this study patient sex, age, type of disease and type of surgical procedure in association with the duration of parenchymal transection, blood loss, length of hospital stay, morbidity and mortality were analyzed. Cool-tip RF device may provide a unique, simple and rather safe method of bloodless liver resections if used properly. It is indicated mostly in cirrhotic patients with challenging hepatectomies (segment Ⅷ, central resections). The total operative time is eliminated and the average blood loss is significantly decreased. It is important to note that this technique should not be applied near the hilum or the vena cava to avoid damage of these structures.展开更多
AIM： To evaluate a series of patients with hepatocellular carcinoma （HCC） treated with several different protocols and devices. METHODS： We treated 138 patients [chronic hepatitis/ liver cirrhosis （Child-Pugh A/...AIM： To evaluate a series of patients with hepatocellular carcinoma （HCC） treated with several different protocols and devices. METHODS： We treated 138 patients [chronic hepatitis/ liver cirrhosis （Child-Pugh A/B/C）, 3/135 （107/25/3）] with two different devices and protocols： cool-tip needle [initial ablation at 60 W （standard method） （n = 37） or at 40 W （modified method） （n = 28）] or; ablation with a LeVeen needle using a standard single-step, full expansion （single-step） method （n = 39） or a multi-step, incremental expansion （multi-step） method. RESULTS： Eleven patients experienced rapid and scattered recurrences 1 to 7 mo after the ablation. Nine patients were treated by the cool-tip original protocol （60 W） （9/37 = 24%） and the other two by the LeVeen single-step method （2/39 = 5%）. The location of the recurrence was surrounding and limited to the site of ablation segment in three cases, and spread over one Iobule or both Iobules in the other eight cases. There was no recurrence in the patients treated with the modified cool-tip modified method （40 W） or the LeVeen multi-step method. CONCLUSION： There is a risk of rapid and scattered recurrence after RFA, especially when the standard cool- tip procedure is used. Because such recurrence would worsen the prognosis, we recommend that modified protocols for the cool-tip and LeVeen needle methods should be used in clinical practice.展开更多
Electroreduction of Co(Ⅱ)to metallic cohalt in urea melt is irrevsible in one step.The transfer coeffi-cient of electrode reaction of Co(Ⅱ)+2e=Co(O)and the diffusion coefficient of Co(Ⅱ)were determined.The lanthanu...Electroreduction of Co(Ⅱ)to metallic cohalt in urea melt is irrevsible in one step.The transfer coeffi-cient of electrode reaction of Co(Ⅱ)+2e=Co(O)and the diffusion coefficient of Co(Ⅱ)were determined.The lanthanum can be inductively codeposited with cobalt. The contents of lanthanum in cobalt-lanthanum de-posts increase with the shift of electrode potential to the negative direction and the raise of La(Ⅲ)/Co(Ⅱ)mo-lar ratio in the melt. The cyclic voltammetry,open circuit potential-time curve after potentiostatic electrolysisand electron probe analyas were used.展开更多
文摘Objective: The aim of this study was to compare the therapeutic efficacy of radiofrequency ablation (RFA) and surgical resection for the patients with hepatocellular carcinoma (HCC). Methods: From January 2002 to June 2009, 87 HCC patients with 3 or fewer nodules, no more than 3 cm in diameter, and liver function of Child-Pugh class A or B were enrolled. Forty-seven underwent RFA while 40 underwent surgical resection. Follow-up ranged from 6 to 69 months. We compared the overall and disease-free survival rate, recurrence patterns, and the complications between the two groups. Survival prob-abilities were estimated using the Kaplan-Meier method. Results: At the end of the study, 67 patients were alive. The 1-, 2- and 3-year overall cumulative survival rates after RFA and surgical resection were 91.0%, 76.7%, 69.7% and 90.0%, 82.9%, 75.4%, respectively. The difference between the two survival curves was not statistically significant (χ2 = 0.99, P = 0.32). Forty-three patients suffered intrahepatic recurrence, including 25 cases after RFA and 18 cases after surgical resection. The 1-, 2-, and 3-year disease-free survival rates after radiofrequency ablation and surgical resection were 57.3% vs 71.1%, 40.3% vs 45.7%, and 35.3% vs 30.9%. The difference between the two groups was not statistically significant (χ2 = 0.06, P = 0.80). Cox hazard model indicated tumor size and Child-Pugh scoring were significant risk factors for local tumor progression, while tumor numbers was risk factor for intrahepatic distant recurrence. Conclusion: RFA is as effective as surgical resection for the treatment of patients with HCC (≤ 5 cm), especially for those who are not suitable for curative resection.
文摘Liver resections are demanding operations which can have life threatening complications although they are performed by experienced liver surgeons. Recently new technologies are applied in the field of liver surgery, having one goal: safer and easier liver operations. The aim of this article is to address the issue of bloodless liver resection using radiofrequency energy. Radionics, Cool-tipTM System and Tissue Link are some of the devices which are using radiofrequency energy. All information included in this article, refers to these devices in which we have personal experience in our unit of liver surgery. These devices take advantage of its unique combination of radiofrequency current and internal electrode cooling to perform sealing of the small vessels and biliary radicals. Dissection is also feasible with the cool-tip probe. For the purposes of this study patient sex, age, type of disease and type of surgical procedure in association with the duration of parenchymal transection, blood loss, length of hospital stay, morbidity and mortality were analyzed. Cool-tip RF device may provide a unique, simple and rather safe method of bloodless liver resections if used properly. It is indicated mostly in cirrhotic patients with challenging hepatectomies (segment Ⅷ, central resections). The total operative time is eliminated and the average blood loss is significantly decreased. It is important to note that this technique should not be applied near the hilum or the vena cava to avoid damage of these structures.
文摘AIM： To evaluate a series of patients with hepatocellular carcinoma （HCC） treated with several different protocols and devices. METHODS： We treated 138 patients [chronic hepatitis/ liver cirrhosis （Child-Pugh A/B/C）, 3/135 （107/25/3）] with two different devices and protocols： cool-tip needle [initial ablation at 60 W （standard method） （n = 37） or at 40 W （modified method） （n = 28）] or; ablation with a LeVeen needle using a standard single-step, full expansion （single-step） method （n = 39） or a multi-step, incremental expansion （multi-step） method. RESULTS： Eleven patients experienced rapid and scattered recurrences 1 to 7 mo after the ablation. Nine patients were treated by the cool-tip original protocol （60 W） （9/37 = 24%） and the other two by the LeVeen single-step method （2/39 = 5%）. The location of the recurrence was surrounding and limited to the site of ablation segment in three cases, and spread over one Iobule or both Iobules in the other eight cases. There was no recurrence in the patients treated with the modified cool-tip modified method （40 W） or the LeVeen multi-step method. CONCLUSION： There is a risk of rapid and scattered recurrence after RFA, especially when the standard cool- tip procedure is used. Because such recurrence would worsen the prognosis, we recommend that modified protocols for the cool-tip and LeVeen needle methods should be used in clinical practice.
文摘Electroreduction of Co(Ⅱ)to metallic cohalt in urea melt is irrevsible in one step.The transfer coeffi-cient of electrode reaction of Co(Ⅱ)+2e=Co(O)and the diffusion coefficient of Co(Ⅱ)were determined.The lanthanum can be inductively codeposited with cobalt. The contents of lanthanum in cobalt-lanthanum de-posts increase with the shift of electrode potential to the negative direction and the raise of La(Ⅲ)/Co(Ⅱ)mo-lar ratio in the melt. The cyclic voltammetry,open circuit potential-time curve after potentiostatic electrolysisand electron probe analyas were used.
