射频凝固电极在肝癌切除或消融治疗中的应用

目的评价射频凝固电极消融技术在肝切除术中应用的可行性、安全性及疗效。方法采用射频凝固电极射频消融技术进行肝癌切除手术共16例，其中腹腔镜下射频消融后肝切除术9例，腔镜下射频消融6例（共13个瘤体，平均最大肿瘤直径3．0-4-1．0em），小切口腹腔镜辅助右肝V、Ⅷ段肝癌切除1例。观察术后并发症情况，肿瘤复发情况。结果16例均顺利完成肝癌切除或消融治疗。未出现严重并发症。肝癌消融灶完全坏死率为92．3％。随访8～20个月（平均14个月），于术后3、6个月各发现1例肝脏出现新病灶，1例消融部位肿瘤残留。肝癌切除患者未出现新病灶。死亡1例。结论腹腔镜下手术或开腹术中射频凝固电极消融技术在肝癌切除或消融治疗中应用安全可行，效果好。选择远离肝门区肿瘤进行治疗时效果更佳。

The application of the hepatectomy or ablation with radio frequency electrode to treat liver cancer

Objective To evaluate the effect, safety and feasibility of the technology of radio frequency ab- lation （RFA） to treat liver cancer. Methods Using the technology of RFA to treat 16 primary and metastatic liver cancer patients in laparoscope operation or celiotomy. Of the total, 6 patients（ 13 focus in all, the average max diameter 3.0 ＋ 1. Ocm） treated by RFA and 9 patients practiced by hepatectomy after RFA in laparoscope operation while another treated with hepatectomy after RFA in celiotomy, than observed the situation of the post- operative complications and the tumor recurrence. Results All patients had successfully treated by RFA （ or/ and） hepatectomy with no serious complications. The complete necrosis rate of tumor was reach up to 92.3%. With 8-20 month （average 14 month） follow-up, two patients were found tumor recurrence respectively at post- operative 3 month and 6 month, and one had tumor remain while no new tumor focus were found in all patients which treated by hepatectomy. Conclusions The hepatectomy and ablation with RFA is effective, safety and feasible to treat liver cancer in laparoscope operation or celiotomy. The therapeutic effect will be better when the tumor is far away from the hepatic hilar region.