射频消融辅助肝切除术的临床应用探索

Clinical application research of radiofrequency-assisted hepatic resection

目的分析射频消融辅助肝切除术的安全性和临床疗效。方法回顾性分析我院2010年3月～2012年11月26例肝胆疾病应用射频消融辅助肝切除术的临床疗效。结果成功完成26例肝切除术,其中肝细胞癌16例、胆管细胞癌5例、肝海绵状血管瘤2例、胆囊癌3例。全部完整切除。26例患者中右半肝切除5例,左半肝切除6例,左外叶+方叶+尾状叶切除2例,中肝叶切除2例,余11例为不规则肝叶段切除。平均切除时间为(54±20)min,出血量为(174±100)ml。所有患者术中生命体征平稳,术后发生胆汁漏3例、胸腔积液3例,均经积极非手术治疗痊愈。全组患者无术后腹腔内出血、肝功能衰竭、伤口感染和围手术期死亡。术后平均住院时间为(20±8)d。结论射频辅助肝切除术具有安全、高效特点,值得临床推广应用。

Objective To investigate the clinical efficacy and safety of radiofrequency-assisted hepatic resection. Methods From Mar 2010 to Nov 2012, we treated 26 hepetobiliary patients by mdiofrequency-assisted hepatic resection. Clinical data were analyzed retrospectively. Results Ten patients including hepatic cellular cancer in six patients, cholangiocellular carcinoma in two patients, cavernous hemangioma of the liver in none patient, carcinoma of gallbladder in one patient. All patients received hepatectomy, including right hepatecomy in one patient, left hepatectomy in one patient, central bisegmentectomy in one patient, non-regular hepatic lobectomy in six patients. The mena operation time was （54±20） minutes and the mean blood loss was （174 ± 100） ml. One patient was complicated with bile leakage, three wih pleura1 effusion, and they were cured by non-surgical treatment. There were no patients with postoperative hemorrhage, incision infection or hepatic failure. No mortality was observed. The mean postoperative hospital stay was （20 ± 8 ） days. Conclusion FR-assisted liver resection appears to be efficacious and safe for disintegrating and removing renal calculi.