腹腔镜下应用微波技术治疗肝癌

Treatment of hepatic carcinoma with laparoscopic microwave coagulation

目的探索微创性治疗肝癌的新途径。方法１９９５年８月～１９９６年１０月应用腹腔镜和微波技术，对２例周边型肝癌病人行微波凝固止血后肿瘤切除，５例不能手术切除的肝癌病人行肿瘤病灶微波固化治疗。结果２例肝切除者，１例术后６个月复发，但２例存活时间均达２０个月。微波固化者存活时间６～１６个月。结论微波凝固止血可有效地控制肝切面的渗血，从而减少了腹腔镜切肝的风险和困难。微波固化可使２ｃｍ范围内的肝组织凝固坏死，肝癌细胞失活。对于不可切除的晚期肝癌或伴有严重肝损害不宜手术切除的肝癌，是一种简便、安全、微创而有效的治疗方法。

Objective In order to search a new minimal damage method of treatment for advanced hepatic carcinoma. Methods From August 1995 to October 1996, a total of 7 patients with advanced hepatic carcinoma had been treated by laparoscopic microwave coagulation. Of them, two cases had been resected with microwave coagulation and 5 cases underwent microwave coagulation therapy. Results Of the 2 patients with tumor resected, one recurred 6 months postoperatively, but both cases survived over 20 months. The others treated with microware coagulation therapy (sokidication) around the tumors survived for 6 months to 16 months. Conclusions Microwave coagulation makes the tissue coagulated and devitalized necrosis 2cm surrounding electrodes. Microwave coagulation effectively decreases blood oozing from hepatic wound surface and minimizes the risk of laparoscopic hepatectomy. Microwave coagulation is a simple, safe, effective and minimal damage method for the unresectable advanced hepatic carcinoma or the patients with severe liver damage and unsuitable for tumor resection.