Iannitti D A, Dupuy D E
Brown University School of Medicine, Providence, RI 02905, USA.
Semin Laparosc Surg. 2000 Jun;7(2):118-28.
The introduction of laparoscopy for diagnosis of abdominal tumors has also allowed for the destruction of hepatic metastases by cryotherapy and radiofrequency ablation. The advantage of laparoscopically based therapy over the percutaneous treatment is the benefit of finding additional lesions that preoperative studies may not have detected. The results from available data in patients with metastatic colorectal carcinoma suggest an improvement in survival. Tumor ablation in patients offers an 18- to 36-month median survival and the possibility of 50% and 24% survival rates at 2 and 5 years, respectively. Patients with metastases from melanoma, breast, esophagus, lung, stomach, pancreas, and gynecologic malignancies have historically not demonstrated improved survival after hepatic resection. The value of hepatic tumor ablation for metastases from these lesions remains undetermined.
腹腔镜检查用于腹部肿瘤诊断的引入，也使得通过冷冻疗法和射频消融来破坏肝转移瘤成为可能。基于腹腔镜的治疗相对于经皮治疗的优势在于，能够发现术前检查可能未检测到的其他病变。转移性结直肠癌患者的现有数据结果表明生存率有所提高。对患者进行肿瘤消融后的中位生存期为18至36个月，2年和5年生存率分别为50%和24%。黑色素瘤、乳腺癌、食管癌、肺癌、胃癌、胰腺癌和妇科恶性肿瘤转移患者，既往肝切除术后生存率并未改善。肝肿瘤消融对这些病变转移的价值仍未确定。
