腹腔镜射频消融治疗乙型肝炎肝硬化并发小肝癌

Laparoscopic radiofrequency ablation therapy in patients with small hepatocellular carcinoma

目的探讨腹腔镜射频消融(LRFA)治疗小肝癌的可行性、安全性及疗效。方法采用LRFA法治疗8例乙型肝炎肝硬化并发小肝癌患者,共9个瘤体,肿瘤均位于肝脏表面、肝左外叶、近膈顶或邻近胆囊等空腔脏器。肝功能均为Child A或Child B级。结果所有患者均顺利完成手术,均未中转开腹,未出现大出血、胆道、膈肌及胃肠道灼伤等并发症;术后一月行影像学检查发现肿瘤坏死率为88.9%(8/9),平均随访13.5个月,均未出现复发及转移。结论 LRFA治疗小肝癌安全、有效,并发症少。

Objective To investigate the feasibility,safety and efficacy of laparoscopic radiofrequency abla- tion （LRFA）therapy for patients with small hepatoceUular carcinoma. Methods Eight patients with small hepatocellular carcinoma with a total of 9 tumors were treated by LRFA. All patients were of Child A or Child B class of liver tunction. Results LRFA was successfully performed in all the patients and no case was transferred to opening conventional surgery. There was no complications found such as abdominal bleeding,biliary tract, diaphragmatic and gastrointestinal tract damage,etc. Checked-up one month after the operation,complete tumor necrosis was achieved in 88.9%（8/9）of the patients. During a followed-up period of average 13.5 months,no cases had been found metastasis or recurrence. Conclusion LRFA therapy is a feasible,safe and effective treatment for selected patients with small liver cancer.