Ishikawa T, Kohno T, Shibayama T, Fukushima Y, Obi S, Teratani T, Shiina S, Shiratori Y, Omata M
Dept. of Gastroenterology, Tokyo University Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan.
Endoscopy. 2001 Aug;33(8):697-702. doi: 10.1055/s-2001-16216.
Percutaneous interstitial thermal ablation therapy effectively treats hepatocellular carcinoma (HCC) that can be visualized on percutaneous ultrasonography. However, when the tumor is located just under the top of the diaphragm, visualization can be difficult with conventional ultrasonographic examination. There are also problems concerning complete tumor ablation. We performed thoracoscopic thermal ablation therapy for HCC located just beneath the diaphragm in nine patients with advanced liver cirrhosis.
Eight patients underwent thoracoscopic microwave coagulation therapy, and one patient underwent thoracoscopic radiofrequency ablation therapy.
Despite the poor hepatic reserve, postoperative recovery after thoracoscopic thermal ablation therapy was rapid in all patients, without deterioration of hepatic function.
This preliminary study suggests that the new technique of thoracoscopic thermal ablation therapy is a less invasive optional therapy for HCC located in segments VII or VIII in cirrhotic patients.
经皮间质热消融疗法可有效治疗经皮超声检查可见的肝细胞癌（HCC）。然而，当肿瘤位于膈肌顶部正下方时，常规超声检查可能难以实现可视化。此外，在肿瘤完全消融方面也存在问题。我们对9例晚期肝硬化患者位于膈肌正下方的HCC进行了胸腔镜热消融治疗。
8例患者接受了胸腔镜微波凝固治疗，1例患者接受了胸腔镜射频消融治疗。
尽管肝脏储备功能较差，但所有患者胸腔镜热消融治疗后的术后恢复均较快，肝功能未恶化。
这项初步研究表明，胸腔镜热消融治疗新技术是肝硬化患者位于VII或VIII段的HCC的一种侵入性较小的可选治疗方法。
