论文部分内容阅读
目的:探讨腹腔镜直视引导定位下肝癌射频热凝消融治疗(radio-ferquency abla-tion,RFA)的可行性。方法:在腹腔镜直视引导定位下分别对10例原发性肝癌和多发转移性肝癌进行一次性射频消融治疗。结果:10例患者28个瘤体中直径<5 cm的20个肿瘤均获得一次性热凝损毁,其中18个瘤体完全缓解CR 90.0%(18/20),2个瘤体部分缓解PR 10.0%(2/20),近期疗效CR+PR为100.0%(20/20),1例术后15个月肝、肺转移复发;8个直径5～9 cm的瘤体近期疗效为CR+PR 100.0%(8/8),CR 50.0%(4/8),PR50.0%(4/8),1例术后6个月发生肝门部转移及阻塞性黄疸而病情进展死亡,1例术后14个月因肝脏、肺脏广泛转移死亡。术后2周复查AFP、CEA和CA19-9等肿瘤标志均有不同程度的下降或转阴。所有患者均很好地耐受了射频消融治疗,无严重并发症出现。9例患者术后分别行1～4次肝动脉化疗栓塞介入治疗(TACE)。1年生存率为85.7%(6/7),2年生存率为50.0%(3/6)。结论:腹腔镜直视引导定位下肝癌射频消融治疗为不能手术的原发性肝癌及多发性肝转移癌提供了一种微创、安全、有效、方便的治疗方法,与TACE结合效果更佳。
Objective: To investigate the feasibility of radio-frequency ablation (RFA) guided by laparoscopic direct-guided positioning of liver cancer. Methods: A total of 10 cases of primary liver cancer and multiple metastatic liver cancer underwent radiofrequency ablation under laparoscopic direct vision guided positioning. Results: All of the 20 tumors with diameter less than 5 cm in 10 of 10 patients had one-time thermal coagulation damage, of which 18 tumors completely relieved CR 90.0% (18/20) and two tumors partially relieved PR 10.0 % (2/20). The short-term effect of CR + PR was 100.0% (20/20). One case had recurrence of liver and lung metastases 15 months after operation. The short-term curative effect of CR + PR 100.0% (8/8), CR 50.0% (4/8) and PR50.0% (4/8). One patient died of hilar metastasis and obstructive jaundice 6 months after operation. One patient 14 months after the death of the liver, lung extensive metastasis. 2 weeks after the review of AFP, CEA and CA19-9 and other tumor markers have varying degrees of decline or negative. All patients were well tolerated radiofrequency ablation without serious complications. Nine patients received postoperative arterial chemoembolization of 1 to 4 times (TACE). The 1-year survival rate was 85.7% (6/7) and the 2-year survival rate was 50.0% (3/6). Conclusion: The laparoscopic direct-guided radiofrequency ablation of hepatocellular carcinoma provides a minimally invasive, safe, effective and convenient treatment for inoperable primary liver cancer and multiple liver metastases, and has a better combination with TACE.