腹腔镜下尾状叶肝细胞癌一次性完全射频消融的可行性及安全性评价

The feasibility and safety of laparoscopic one-off complete radiofrequency ablation for hepatocellular carcinoma in caudate lobe

目的评价腹腔镜下尾状叶肝细胞癌（HCC）一次性完全射频消融（RFA）的可行性与安全性。方法解放军总医院2009年12月-2010年12月连续收治的尾状叶HCC患者10例,男9例,女1例,平均年龄48（32-65）岁,Child-Pugh A级9例,B级1例,肿瘤平均直径2.6（1.8-3.2）cm。腹腔镜下进行射频消融治疗,观察射频消融区域肝组织颜色、温度以及鼻温变化。结果 10例患者消融结束时,消融区域平均温度86.4（83-97）℃,鼻温平均升高1.5（1.1-2.0）℃。肿瘤消融术后无其他补充治疗,术后6个月复查均无局部复发征象,达到了一次性完全消融。随访24-36个月,所有患者生存良好。结论腹腔镜下对尾状叶肝细胞癌施行一次性完全射频消融是安全可行的。

Objective To assess the feasibility and safety oflaparoscopic one-off complete radiofrequency ablation （RFA） for hepatocellular carcinoma （HCC） in caudate lobe. Methods Ten patients （9 males and 1 female） with caudate lobe HCC were treated by laparoscopic RFA in the General Hospital of PLA from Dec. 2009 to Dec. 2010. The mean age of the patients was 48 years （ranged from 32 to 65）. Nine cases were Child-pugh A, and one was Child-Pugh B. The mean diameter of tumors was 2.6cm （1.8-3.2cm）. The mean follow-up period for focal recurrence was 6 months to evaluate the result of one-off tumor complete ablation. Results The monitored mean temperature of ablation area was about 86.4 ℃ （83-97 ℃）, and the elevation of body temperature as measured in nose was 1.5 ℃（1.1-2.0 ℃ ） just after the procedure of ablation was terminated. No additional therapy was needed after RFA, no single focal recurrence appeared 6 months after the procedure of ablation, and the survival condition was satisfactory during 24-36 months of follow-up period. Conclusion The laparoscopic one-off complete RFA for HCC situated in caudate lobe is safe and feasible.