腹腔镜下超声引导射频治疗小肝癌(附2例报道)

Laparo-assisted ultrasonic- guided radio-frequency ablation in the treatment of small hepatoma (2 cases report)

目的探讨腹腔镜下超声引导射频(LARF)治疗小肝癌(直径≤3.0cm)的优点及价值。方法腹腔镜下腹腔镜超声结合腹壁超声引导射频治疗小肝癌。2例患者均为男性,合并乙型肝炎肝硬化、门脉高压症,年龄43、66岁,Child-pugh评分A级,肿瘤毗邻肝内较大管道系统和/或肝脏周围脏器,直径1.7～2.3cm,超声准确定位后腹腔镜辅助进行射频消融,治疗后2周复查超声造影及甲胎蛋白(AFP),以判断射频消融疗效。结果2例患者术后均无并发症或死亡,消融范围超出原肿瘤0.5～2.2cm,AFP逐渐下降。结论腹腔镜下超声引导射频治疗小肝癌有诸多优点,对于不可切除小肝癌、肿瘤毗邻肝内较大管道系统和/或肝脏周围脏器的小肝癌,特别是合并肝硬化门脉高压症者,是一种安全有效且值得推广的微创疗法。

[Objective] To probe into the forte and usefulness of the radiofrequency ablation in the treatment of small hepatoma（diameter≤3.0 cm） with laparosoope assisting and ultrasonic guidance. [Methods] With the aid of laparoseope and the guidance of combination of laparo and traditional ultrasound, small hepatoma was treated with radiofrequeney ablation. 2 patients （age 43 and 66 yrs.beth men, beth of HBV positive; beth in Child-pugh＂ s Class A） with small hepatoma （Range of diameter：1.7-2.3 cm） rising from cirrhosis and portal hypertension. All the tumors were located near the intrahepatie piping system and/or other eireum-hepatic organs. Ultrasonic visualization in beth of the patients was carried out and the value of AFP was obtained respectively 2 weeks after LARF to assess treatment efficacy. [Results] No mortality or morbidity occurred. The diameter of the ambit of the ablation was 0.5-2.2 cm longer than the prior, and the value of AFP fell off. [Conclusion] The treatment of small hepatoma with LARF is a safe and minimally invasive procedure which is strongly recommended for unreseetable hepatoma or hepatoma that is located near the intrahepatie piping system and/or other eircum-hepatie organs, especially for the patients sufferring-from complication of cirrhosis and portal hypertension.