腹腔镜射频消融治疗原发性肝癌的研究

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：51例原发性肝癌在全麻下行腹腔镜RFA治疗，共72个瘤体，平均最大肿瘤直径（3．4±1．0）cm。合并肝硬化49例、慢性结石性胆囊炎5例，糖尿病4例，凝血功能障碍10例。结果：51例均顺利完成腹腔镜RFA治疗，12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12～58个月（平均35个月），6例发现肝内新病灶，11例射频治疗部位复发，再次采用经皮RFA治疗9例，12例死于肿瘤复发或肝功能衰竭。结论：腹腔镜RFA治疗原发性肝癌安全可行，治疗效果可靠，但应选择瘤体位于肝脏表面或临近胆囊而且不宜手术切除的病例进行治疗。

Laparoscopic radiofrequency ablation therapy for hepatocellular carcinoma

Objective： To evaluate the feasibility, safety and efficacy of laparoscopic radiofrequency ablation （RFA） therapy in patients with hepatocellular carcinoma （HCC）. Methods： Fifty -one HCC patients with 72 tumors were submitted to laparoscopic RFA therapy under general anesthesia, with an average maximum tumor diameter of 3.4 ± 1.0 cm. The liver cirrhosis was diagnosed in 49 patients. Five patients had chronic calculous cholecystitis, d diabetes and 10 coagulation disorders. Results： Laparoscopic RFA was successfully performed in the 51 patients, and laparoscopic cholecystectomy was performed simultaneously in 12 patients. No severe complication was observed in all the patients. The complete necrosis rate of tumor was 95.8%. During a median follow-up period of 35 months （range, 12 -58 months）, 6 patients had new malignant nodules, 11 patients locally recurred at the ablation site, and 9 patients received percutaneous RFA therapy. Twelve patients died from tumor recurrence or liver failure. Conclusion： Laparoscopic RFA therapy is a feasible, safe and effective treatment modality for selected patients with HCC. Laparoscopic RFA is suitable for inoperable HCC located on the liver surface or adjacent to the gallbladder.