消融术治疗高危部位肝癌相关技术研究进展

Ablation treatment of liver cancers located at high risk areas: research progress of ablation-related technology

消融治疗以其微创、疗效确切及可重复性好等特点,对包括肝细胞肝癌、肝内胆管细胞癌、转移性肝癌等在内的各类型肝癌的起着十分重要的作用。对于≤3 cm的病灶,消融治疗的疗效已可媲美手术切除。但当病灶位于肝门部、膈顶部、大血管旁及毗邻胃肠道等高危部位时,肝癌的消融疗效还不尽如人意。近年来,各种导航技术及消融辅助手段的出现帮助操作者提高了手术成功率,减少了周围脏器损伤,从而使肝癌消融变得更加安全和有效。该文对导航技术及消融术中各种辅助手段的相关原理、临床应用作一综述。

Being a minimally-invasive therapy with reliable curative effect and excellent repeatability, the ablation technique plays a very important role in the treatment of various types of liver cancers, including hepatocellular carcinoma(HCC), intrahepatic cholangiocarcinoma, metastatic liver cancer, etc. For lesions with diameter ≤3 cm, the curative effect of ablation has been comparable to that of surgical resection. But for lesions located at some special sites, such as at the hilum of liver, top of diaphragm, close to large vessels, adjacent gastrointestinal tract, etc. the curative effect of ablation therapy is often not as good as expected. In recent years, various newly-developed navigation techniques and ablation auxiliary means can help operators improve the success rate of operation and reduce the injury of surrounding organs, which makes the ablation therapy of liver cancers more safe and effective. This paper aims to make a comprehensive review about the principles and clinical application of navigation technology and the various auxiliary means in ablation treatment.