经腹腔镜联合腹腔镜超声射频消融治疗多发性肝癌的体会

The Comprehension of Laparoscopes Combined with Laparoscopic Ultrasonography in the Treatment of Multiple Hepatic Carcinoma

目的探讨经腹腔镜联合腹腔镜超声射频消融治疗多发性肝癌的方法及疗效。方法回顾性分析我科2008年3月至2011年5月9例行经腹腔镜联合腹腔镜超声射频消融治疗多发性肝癌患者的临床资料,肿瘤直径1.5～4.8 cm,其中6例为两个病灶,3例为三个病灶。单个病灶射频消融时间10～28 min,术后1周复查超声。结果 21个病灶均在腹腔镜下顺利完成手术,术中出血10～120 ml,术后复查超声造影病灶完全坏死率为90.5%,残余病灶经B超引导再次射频消融治疗。9例患者术后均出现转氨酶升高、发热,3例出现胆红素轻度升高,1例出现少量腹水,无胆瘘、大出血、气胸、脏器损伤等严重并发症的发生。结果经腹腔镜联合腹腔镜超声射频消融治疗多发性肝癌是安全有效的治疗方法,可进一步扩大射频消融术的手术指征。

Objective To approach the method and curative effect of laparoscopes combined with laparoscopic ultra- sonography in treatment of multiple hepatic carcinoma. Methods We retrospectively analyzed the clinical datas of 9 patients with the treatment of laparoseopes combined with laparoscopic uhrasonography during March 2008 and May 2011. The diameters of the tumor varied from 1.5 -4.8 cm. There were 6 cases of two lesions,3 cases for three lesions. The single radiofl＇equeney ablation time varied from 10 -28 rain. Uhrasound contrast were performed for postoperative review 1 week later. Results All Ihe 21 laparoseopie operation were performed successfully. The hemorrhage during operation varied from 10 ml to 120 ml. The rate of total necrosis is 90.5%. Residual lesions were undergone radiofrequeney ablation with the guide of B uhrasoumt. After the treatment,9 patients had developed transient transaminase. Bilirubin mildly elevated in 3 cases. One had small amount of as- cites. There were no severe complications such as biliary fistula,hemorrhage, pneurnothorax,visceral jniury occured. Conclusion It＇ s safe and feasible to perform laparoscopes combined with laparoscopic uhrasonography to treat multiple hepatic carcino- ma. It is feasible for further expand the indications tbr radiofrequency ablation operation.