腹腔镜超声引导微波消融治疗原发性肝癌的疗效分析

Efficacy analysis of ultrasound-guided laparoscopic microwave ablation in the treatment of primary liver cancer

目的:探讨腹腔镜超声引导微波消融术治疗原发性肝癌的临床疗效。方法:选取124例原发性肝癌患者,根据手术方式分为观察组(行腹腔镜超声引导微波消融术,n=62)与对照组(行经皮超声引导微波消融术,n=62),对比分析两组术中新发现病灶、术后并发症、肿瘤完全消融率、局部复发率、肿瘤再发率、相关肿瘤标志物、生存率等相关指标。结果:观察组术中新发现肿瘤病灶18处(10例),对照组术中无新发现病灶,差异有统计学意义(P<0.05);观察组术后并发症发生率(9.7%vs.24.2%)、肿瘤完全消融率(97.1%vs.90.2%)优于对照组,差异有统计学意义(P<0.05);两组局部复发率、肿瘤再发率、相关肿瘤标志物、生存率等差异无统计学意义(P>0.05)。结论:与传统经皮微波消融术相比,腹腔镜超声引导微波消融术治疗原发性肝癌可更好地避免微小病灶的遗漏,具有术后并发症少、肿瘤完全消融率高等优势,值得在临床广泛开展。

Objective:To investigate the clinical efficacy of ultrasound-guided laparoscopic microwave ablation in the treatment of primary liver cancer.Methods:The clinical data of 124 patients with primary liver cancer were retrospectively analyzed,including 62 patients treated with ultrasound-guided laparoscopic microwave ablation(observation group) and 62 patients treated with percutaneous microwave ablation(control group).The new lesions discovered during procedure,postoperative complications,tumor complete ablation rate,local recurrence,tumor recurrence rate,related tumor markers,survival rate were compared between the two groups.Results:There were 18 newly discovered tumor lesions(10 patients) in the observation group while no new lesion was discovered in the control group(P<0.05).The observation group was better than the control group in terms of postoperative complications(9.7% vs. 24.2%,P<0.05) and tumor complete ablation rate(97.1% vs. 90.2%,P<0.05).There was no statistical difference between the two groups in terms of local recurrence rate,tumor recurrence rate,related tumor markers and survival rate(P>0.05).Conclusions:Compared with percutaneous microwave ablation,ultrasound-guided laparoscopic microwave ablation in the treatment of primary liver cancer has the advantages of low incidence of postoperative complications,high complete ablation rate and better elimination of missing lesions.It is worthy of being widely used in clinical practice.