摘要
目的评价射频消融在腹腔镜解剖性半肝切除术治疗肝细胞癌(HCC)中的价值.方法选择单县东大医院2017年1月~2019年12月21例原发性肝细胞癌(HCC)患者作为研究对象,均采用射频消融联合腹腔镜解剖性半肝切除术治疗,观察患者手术时间、术中出血量、术后住院时间,术后并发症发生率及死亡率.所有患者术后均随访12个月,观察术后复发率.结果21例患者均成功完成手术,手术成功率100%;其行左半肝切除术12例,占57.14%,平均手术时间(296.47±25.71)min,术中平均出血量(336.82±43.75)mL,术中实施射频消融平均止血次数(5.37±0.88)次,止血成功率100%;行右半肝切除术9例,占42.86%,平均手术时间(307.52±31.07)min,术中平均出血量(319.60±37.95)mL,术中实施射频消融平均止血次数(5.07±0.63)次,止血成功率100%;所有患者均未行肝门阻断.术后并发症发生率为38.10%,术后平均住院时间(10.42±2.16)d.所有患者术后均随访12个月,6个月肝外肺部转移1例,12个月肝外转移2例,分别为肺和膈肌转移,死亡1例,1年生存率为95.24%.结论射频消融能防治肝肿瘤破裂和正常肝实质破裂出血,巩固安全边界,有利于腹腔镜手术的成功.
Objective To evaluate the value of radiofrequency ablation in the treatment of hepatocellular carcinoma(HCC)by laparoscopic anatomical hemihepatectomy.Methods A total of 21 patients with primary hepatocellular carcinoma(HCC)hospitalized from Januan72017 to December 2019 were treated as the research objects.All were treated with radiofrequency ablation combined with laparoscopic anatomical hemihepatectomy.The operation time and intraoperative time of the patients were observed.Bleeding volume,postoperative hospital stay,postoperative complications and mortality.All patients were followed up for 12 months to observe the postoperative recurrence rate.Results All 21 patients completed the operation successfully,and the operation success rate was 100%;12 patients underwent left hepatectomy,accounting for 57.14%.The average operation time was(296.47±25.71)min,and the average intraoperative blood loss was(336.82±43.75)mL.The average number of times of intraoperative radiofrequency ablation to stop bleeding was(5.37±0.88)times,and the success rate of hemostasis was 100%;9 patients underwent right hepatectomy,accounting for 42.86%,the average operation time was(307.52±31.07)min,and the average intraoperative blood loss(319.60±37.95)mL,intraoperative radiofrequency ablation was performed on average(5.07±0.63)times of hemostasis,and the success rate of hemostasis was 100%;all patients did not undergo hepatic port occlusion.The postoperative complication rate was 38.10%,and the average postoperative hospital stay was(10.42±2.16)clays.All patients were followed up for 12 months after surgery.1 case of extrahepatic lung metastasis was 6 months,2 cases of extrahepatic metastasis were 12 months,lung and diaphragm metastasis respectively,1 case died,and the 1-year survival rate was 95.24%.Conclusion Radiofrequency ablation can prevent the rupture of liver tumors and normal liver parenchymal bleeding,and consolidate the safety margin,which is conducive to the success of lapaioscopic surgery.
作者
周凯
孙光明
唐明杰
刘敬华
ZHOU Kai;SUN Guang-ming;TANG Ming-jie;无(Department of Hepatobiliary and Pancreatic Surgery,Dongda Hospital,Shanxian County,Shandong 274300,China;Department of Biliary Pancreatic Spleen Surgery,Qinghai Provincial People's Hospital 810000;Department of Hepatobiliary and Pancreatic Surgery,Linyi People's Hospital,Shandong 276000,China)
出处
《肝胆外科杂志》
2022年第1期42-45,共4页
Journal of Hepatobiliary Surgery
关键词
射频消融
腹腔镜
解剖性半肝切除术
肝细胞癌
radiofrequency ablation
laparoscopic
anatomical hemihepatectomy
hepatocellular carcinoma
