腹腔镜射频消融治疗原发性肝癌98例报告.docxVIP

腹腔镜射频消融治疗原发性肝癌98例报告来源：创新医学网　　作者：刘玉峰1,罗廷泽1,史宪杰2,梁雨荣2,陈永卫2,徐明月2,吕少诚2　??????? 作者单位：1玛纳斯县人民医院肝胆外科,新疆玛纳斯,832200；2北京解放军总医院全军肝胆外科研究所,100853　　【摘要】目的 评价腹腔镜射频消融(RFA)治疗原发性肝癌的可行性、安全性及疗效。方法 98例原发性肝癌在全麻下行腹腔镜RFA治疗, 共134个瘤体，平均最大肿瘤直径2.5-7.3cm，平均3.1cm。合并肝硬化70例、慢性结石性胆囊炎2例，糖尿病4例，凝血功能障碍8例。结果 96例顺利完成腹腔镜RFA治疗，2例行中转开腹手术，3例行腹腔镜胆囊切除术。未出现严重并发症。肿瘤完全坏死率为95.8%。随访1年, 18例发现肝内新病灶，11例射频治疗部位复发，再次采用腹腔镜RFA治疗3例，采用经皮RFA治疗5例，采用肝动脉栓塞化疗12例。结论 腹腔镜RFA治疗原发性肝癌安全可行，治疗效果可靠，尤其适用于多发病灶、无法耐受手术且不宜手术切除的病例。　　【关键词】肝细胞癌,射频消融,腹腔镜,肝脏　　The clinical application of laparoscopic radiofrequency ablation of primary liver cancer in 98 cases　　【Abstract】 AIM：To evaluate the feasibility, safety and efficacy of laparoscopic radiofrequency ablation(RFA) for primary liver cancer.METHODS：A total of 98 patients with 134 hepatic cancer 2.5-7.3 cm in diameter with the mean size of 3.1 cm,were treated by laparoscopic radiofrequencv ablation therapy at our hospital.liver cirrhosis was found in 70 patients，chronic cholecystitis in 2 patient， diabetes in 4 patients,and coagulation dysfunction in 8 patient.RESULTS：Laparoscopic RFA therapy was performed successfully in 96 patients.3 patients were performed laparoscopiecholecystectomy at the same time.there was 2 patients change to celiotomy.No specific complications developed during or after RFA therapy.the complete coagulative necrosis rates were 95.8% .During a mean follow-up period of 1 year，there were 18 patients with local recurrence at the ablation site, 11 patient having new malignant nodules，Treated by laparoscopic RFA again in 3 cases,treated by percutaneousRFA,in 5 cases with TACE in 12 cases.CONCLUSION：The result of this study indicates that laparoscopic radiofrequency ablation(RFA) is a feasible and safe technique for the treatment of liver malignancies.especially for multiple lesions, unusual regions and can not tolerate surgery patients.　　【Key words】Hepatic cancer Radiofrequency ablation Laparoscope Liver　　原发性肝细胞性肝癌是最常见的恶性肿瘤之一，尤其以乙型肝炎(HBV)所致最多见。肝癌起病隐匿，就诊时大多已属晚期。由于肝硬化基础上的肝癌 及手术后的高复发率