术中B超引导下行肝癌切除术35例临床分析

Intraoperative ultrasonography in preventing recurrence after the resection of hepatocellular carcinoma

目的评价术中B超引导下行肝癌切除术在预防肝癌术后复发的应用价值。方法35例肝癌患者在术中B超引导下行肝癌切除术(A组),另35例行常规肝癌切除术(B组),术后定期复查肝功能、AFP、CT及MRI等,并随访。结果术中B超对直径小于3cm肿瘤检出阳性率为93.1%,直径大于3cm肿瘤检出阳性率为100%。应用术中B超使34.3%(12/35)患者改变了原手术方案。术后5年局部复发率A组为54.3%,B组为88.6%(P<0.05)。结论术中B超对肝癌定位准确,能够提高手术安全性、彻底性和合理性,降低肝癌术后复发率,明显优于常规肝癌切除术。

Objective To evaluate the value of intraoperative ultrasonography（IOUS） in preventing recurrence after the resection of hepatocellular carcinoma. Methods Thirty-five patients underwent the procedure guided by IOUS（group A）and 35 patients underwent conventional resection（group B）, AFP,CT and MRI were used regularly ultrasound during the follow-up period to evaluate the outcome. Results The intraoperative ultrasonography could detect 93.1% tumors whose diameters were less than 3cm and detect 100% tumors whose diameters were larger than 3cm. 34.3% patients undergoing resection of primary carcinoma of liver had the planned procedure changed by IOUS, 5-year local recurrence rates were 54.3 % （group A） and 88.6 % （group B）. Conclusion Intraoperative hepatic ultrasonography can locate the focus accurately,improve surgical safety,make the operation more radical and decrease the recurrent rat,this is more effective than traditional hepatectomy.