冷冻外科治疗肝癌

CRYOSURGERY FOR HEPATIC CANCER

冷冻治疗肝癌113例,其中原发性肝癌(PLC)107例、转移性肝癌(SLC)6例。用盘形冷冻头治疗位于肝浅表肿瘤,单针或多针冷冻头插入瘤体内治疗位于肝深部肿瘤术中B超监测冷冻范围。全组无手术死亡。107例PLC患者冷冻后5年和10年生存率分别为22.0％、8.2％,其中32例PLC≤5cm患者则分别为48.8％、17.1％。6例SLC患者冷冻后平均生存25.2个月(2～90个月)。本文提示:冷冻对手术不能切除肝癌是一种安全、有一定疗效的局部治疗方法。

From November 1973-June 1992, cryosurgery with liquid nitrogen(-196℃) was performed on 113 patients with hepatic cancer, including 107 patients with primary liver cancer (PLC) and 6 patients with secondary liver (SLC). Of the 107 PLC patients, subclinical stage constituted 30.8% (33/107), moderate stage 61 .7% (66/107), and late stage 7. 5% (8/107). There were 32 cases with small PLC (5cm). liver cirrhosis was observed in 86.0% (92/107). We designed flat cryoprobes for the freezing of surface tumors, and single and multiple trocar crocar cryoprobes for the freezing of tumors located deeply in the hepatic parenchyma. Intraoperative ultrasound was used for monitoring hepatic cryolesions. There were no operative mortalitied and complications, such as rupture of tumor , delayed bleeding, or bile leakage. The 5 -year and 10 -year survival rates were 23.0% and 8.2%, respectively, for the 107 PLC patients; 48.8% and 17 .1% , respectively, for the 32 patieh'ts with small PLC. of the 6 SLC patients, survival ranged from 2 months to 90 months (average, 25.2 months). One SLC patients swrvived well for 7 years and 6 months after cryosurgery. These results indicated that cryosurgery, the in situ frheezing of cancer , is a safe and effective treatment for some of unresectable hepatic cancer.