腹腔镜B超引导下微波消融术治疗特殊部位肝癌的疗效观察

Efficacy of ultrasound-guided laparoscopic microwave ablation for hepatocellular carcinoma

目的探讨腹腔镜B超引导下微波消融术治疗特殊部位肝癌的临床疗效。方法回顾性分析特殊部位肝癌患者58例,根据采取的术式不同将患者分为观察组(29例,行腹腔镜B超引导下微波消融术)和对照组(29例,行经皮微波消融术)。观察比较两组患者术中有无新发现的肿瘤病灶、肿瘤病灶消融率、肿瘤再发率、手术时间、术中出血量、住院时间、手术不良反应发生情况等。结果观察组有5例患者在术中发现新的肿瘤病灶,而对照组患者未在术中新发现肿瘤病灶,两组比较差异有统计学意义(P<0.05)。观察组患者肿瘤病灶消融率高于对照组(93.10%vs 75.86%,P<0.05),肿瘤再发率低于对照组(3.45%vs 13.79%,P<0.05)。两组患者手术时间、术中出血量及住院时间比较均无统计学差异(均P>0.05)。观察组患者手术不良反应发生率低于对照组(10.34%vs 24.14%,P<0.05)。结论相较于经皮微波消融术,腹腔镜B超引导下微波消融术治疗特殊部位肝癌,肿瘤病灶消融率高,肿瘤再发率低,且手术并发症发生率低,有进一步研究的临床意义。

Objective To evaluate the efficacy of B ultrasound-guided laparoscopic microwave ablation forhepatocellular carcinoma(HCC).Methods Clinical data of58patients with HCC,including29cases treated with Bultrasound-guided laparoscopic microwave ablation(laparoscolic group)and29cases treated with percutaneous microwaveablation(control group),were retrospectively reviewed.The new lesions discovered during procedure,tumor ablation rate,tumorrecurrence rate,operation time,volume of intraoperative bleeding,length of stay,adverse reactions during procedure werecompared between two groups.Results New tumor lesions were found in5patients of laparoscopic group,while no new lesionwas discovered in control group(P<0.05).The tumor ablation rate was higher and the recurrence rate was lower in laparoscopicgroup than those in control group(93.10%vs.75.86%and3.45%vs.13.79%,respectively,both P<0.05).There were nosignificant differences in operation time,volume of intraoperative bleeding and the length of stay between two groups(P>0.05).The occurrence rate of adverse reactions in laparoscopic group was lower than that in control group(10.34%vs24.14%,P<0.05).Conclusion Comparedwithpercutaneousmicrowaveablation,Bultrasound-guidedlaparoscopicmicrowaveablationismoreeffectivewithalowerrecurrencerateandcomplicationrateintreatmentofhepatocellularcarcinoma.