腹腔镜诊断和治疗小肝癌临床研究的初步报告

Laparoscopy in diagnosis and treatment of early-stage primary hepatoma

目的 探讨腹腔镜对AFP阳性、而影像学检查阴性的小肝癌的诊断和治疗的价值。方法 对 5例AFP阳性、而B超、CT或 (和 )MRI阴性 ,高度怀疑早期肝癌者 ,进行了腹腔镜探查和手术治疗。结果 5例均证实为小肝癌 ,肿瘤约 0 8～ 1 0cm ;4例实施了腹腔镜肝部分切除 ,1例中转开腹手术切除肿瘤。随访 4个月至 4年 ,5例均无瘤生存。结论 对AFP持续阳性 >1个月、而B超、CT或 (和 )MRI阴性 ,高度怀疑肝表面小肝癌者 ,进行腹腔镜探查和手术治疗可能是肝表面或肝边缘的小肝癌最佳的诊断和治疗手段。

Objective To determine the value of laparoscopy in diagnosis and treatment of early-stage primary hepatoma. Methods From March 1998 to March 2002, 5 AFP-positive patients with primary hepatoma were diagnosed and treated with laparoscopy in our hospital. However, no positive findings were obtained from the 5 patients by B-mode ultrasonography and CT and/or MRI. Results Early-stage primary hepatoma was diagnosed in all the 5 patients. The diameter of the tumor was 0.8-1.0 cm. Four patients received laparoscopic hepatectomy and 1 open hepatectomy. The postoperative tumor-free survival was 0.3-4 years in all the patients. Conclusions Laparoscopy might be the best choice for diagnosis and treatment of AFP-positive early-stage primary hepatoma with negative findings during examinations by B-mode ultrasonography, CT and/or MRI.