腹腔镜下微波消融术治疗肝癌的临床疗效观察

目的:探讨腹腔镜下微波消融术治疗肝癌的临床疗效。方法:自2011年6月共为14例(19个病灶)肝癌患者行腹腔镜下微波消融术。术前行腹部增强CT或B超检查,观察术后并发症、肝功能、AFP等指标,以评估其临床疗效。结果:14例手术均顺利完成。术后发热8例,疼痛10例,无术后出血、胆漏、消化道穿孔等严重并发症发生。1例残留病灶,术后在B超引导下行经皮微波消融治疗;2例新发病灶,均行选择性肝动脉化疗栓塞术治疗,1例死于肝功能衰竭。结论:腹腔镜下微波消融结合了腹腔镜及微波消融的微创特点,患者创伤小,疗效确切,手术安全可行,尤其适于突出肝脏表面及病灶邻近胆囊的患者。

Observation of clinical effect of laparoscopic microwave ablation for hepatic carcinoma

Objective：To investigate the clinical effect of laparoscopic microwave ablation for hepatic carcinoma. Methods： Since Jun. 2011,14 patients of liver cancer with a total of 19 lesions had been treated with laparoseopic microwave ablation. The clinical efficacy was assessed by observing the occurrence of postoperative complications,liver function, AFP, enhanced abdominal CT and B-ul- trasound. Results：Laparoscopic microwave ablation was successfully performed in all the patients. 8 patients had fever and 10 patients complained pain, and no postoperative bleeding, hiliary fistula or gastrointestinal perforation occurred. Incomplete of ablation was found in 1 patient, and treated by ultrasound guided microwave ablation. There were 2 recurrences which were treated by transcatheter arterial chemoembolization. One patient died of liver failure. Conclusions：Combining the advantages of laparoscopy and microwave ablation, laparoscopie microwave ablation is safe and feasible,has few trauma and outstanding curative effects, especially for the tumors in liver surface and closed to gallbladder.