射频消融辅助下前入路右半肝切除术与传统右半肝切除术治疗肝脏中部肿瘤的对比研究

Radiofrequency ablation-assisted anterior approach right hepatectomy versus conventional right hepatectomy for central liver tumors

目的:比较射频消融(RFA)辅助下前入路右半肝切除术与传统右半肝切除术治疗肝脏中部肿瘤的疗效及安全性。方法:将60例肝脏中部肿瘤患者按照随机数字法均分为对照组与观察组。对照组行传统右半肝切除术,观察组行RFA辅助下前入路右半肝切除术。比较两组手术情况、住院时间、并发症发生率与5年生存率等。结果:两组在手术时间差异无统计学意义(P>0.05),但观察组出血量、术中肿瘤破裂例数、术中大出血例数、输血例数及住院时间均明显少于对照组(均P<0.05);对照组总并发症发生率为46.67%,观察组为36.67%,两组差异无统计学意义(P>0.05);Kaplan-Meier分析显示对照组5年生存率43.09%,观察组为65.73%,两组差异有学意义(P<0.001)。结论:射频消融辅助下前入路右半肝切除术治疗肝脏中部肿瘤的效果显著,明显优于传统右半肝切除术。

Objective： To compare the efficacy and safety ofradiofrequency ablation （RFA）-assisted anterior approach right hepatectomy between conventional right liver resection for central liver tumors. Methods： Sixty patients with central liver tumor were equally designated, using random number table, to control group and observational group. Patients in control group underwent conventional right liver resection, and patients in observational group underwent RFA-assisted anterior approach hepatectomy. The intraoperative conditions, length of postoperative hospital stay, incidence of postoperative complications and S-year survival between the two groups were compared. Results： There was no statistical difference in operative time between the two groups （P〉0.05）, however, the intraoperative blood loss, the number of cases with intraoperative tumor rupture and massive haemorrhage,the number of cases requiring blood transtusion and length of postoperative hospital stay were significantlyreduced in observational group compared with control group （all P〈0.0S）. The overall incidence of postoperative complications in control group and observational group was 46.67% and 36.67% respectively, and the difference between them had statistical significance （P〉0.0S）. Kaplan-Meier analysis showed that the S-year survival rate in control group and observational group was 43.09% and 65.73% respectively, and the difference between them was statistically significant （P〈0.001）. Conclusion： RFA-assisted anterior approach right hepatectomy has demonstrable efficacy in treatment of central liver tumors, and is superior to the conventional right liver resection.