肝转移癌腹腔镜射频消融与直肠癌开腹切除序贯治疗的应用

目的:探讨肝转移癌腹腔镜射频消融与原发直肠癌开腹切除序贯治疗的应用优势.方法:全麻下先用腹腔镜技术对肝转移癌行射频消融,再对原发直肠癌病灶行开腹直肠癌根治术.结果:本组总手术时间3.5～5.5h,平均4.1h,射频时间20～75min,平均40min.直肠癌根治性切除术中出血200～400ml,平均280ml;射频消融...

Sequential treatment of laparoscopic radio frequency ablation for hepatic metastases and open resection of rectal cancer

Objective:To investigate the application superiority of sequential treatment which includes laparoscopic radio frequency ablation for hepatic metastases and open resection of primary rectal cancer. Methods:Laparoscopic radio frequency ablation was applied to hepatic metastases under general anesthesia,and then primary rectal cancer was resected by open radical surgery. Results:The total operative time was 3.5-5.5h,with the average of 4.1h.Time of ablation was 20-75min(mean 40min).Blood loss during radical resection of rectal cancer was 200-400ml(mean 280ml);the blood loss during ablation was less than 10ml.The total ruin rate of liver metastases was 98%.The transaminase,γ-glutamyl transpeptidase and bilirubin increased in 8 cases.The transaminase was 300-500U/L,γ-glutamyl transpeptidase was 1 000-1 200U/L,and bilirubin was 60-80μmol/L.They returned to normal after 1 week of liver protection treatment.Hemorrhage in ablation site occurred in 2 cases,one was in caudate lobe,and the other was at giant metastases in right hepatic lobe,the blood loss was 800ml and 400ml,which recovered after symptomatic treatment.Hospital stay was 11.3-14.2d,with the average of 12.5d. Conclusions:In one time of anesthesia,the sequential treatment which contains laparoscopic radio frequency ablation for hepatic metastases and open resection of primary rectal cancer,resects primary lesion and ablates the secondary lesion.It is worthy of generalization because of mini-invasion,short operative time and quick recovery.