结肠直肠癌肝转移的射频消融治疗

Radiofrequency ablation therapy for colorectal cancer liver metastases

目的:评价结直肠癌肝转移(colorectal cancer liver metastases,CRLM)射频消融(radiofrequency ablation,RFA)治疗的可行性。方法:2003年12月至2008年11月67例结直肠癌肝转移患者在西安交通大学医学院第一附属医院接受了RFA治疗。根据实施RFA治疗的方法将患者分成3组:经皮穿刺RFA(第1组)、开腹RFA(第2组)或经皮RFA与手术相结合的方法(第3组)。结果:RFA后90天,3组的死亡率均为零。一半的患者(34/67)出现手术后轻度发热。1/4的患者(17/67)有右肩部与右季肋部疼痛或不适。1例并发结肠瘘。随访显示1年、3年和5年生存率分别是100%、34.3%和4.5%。结论:对CRLM的患者,RFA或结合肝切除手术是相对微创、安全可行的方法,而且致死率低。

Objective： To appraise viability in the treatment of CRLM with radiofrequency ablation（ RFA）. Methods： Sixty- seven patients underwent RFA for CRLM at First Affiliated Hospital of Medical College of Xi＇an Jiaotong University between December 2003 and November 2008. All patients were divided into three groups according to whether RFA technique through a percutaneous method,surgical approach or both percutaneous and surgical approaches. Results： Mortality after 90 days was zero in 3 groups. Half of the patients（ 34 /67） had mild fever postoperatively. A quarter of the patients（ 17 /67） had the right shoulder or / and hypochondrium pain or discomfort. The complication of colon fistula occurred in one case. Follow- up showed that 1-,3- and 5- year survival rates were 100%,34. 3% and 4. 5%. Conclusion： RFA or with hepatic resection to CRLM is relatively microinvasive and a safe as well as feasible procedure with lower fatality.