Popescu I, Sîrbu-Boeţi M P, Tomulescu V, Ciurea S, Boroş M, Hrehoreţ D, Jemna C
Centrul de Chirurgie Generală şi Transplant Hepatic, Institutul Clinic Fundeni, Bucureşti.
Chirurgia (Bucur). 2005 Mar-Apr;100(2):111-20.
The aim of our study was to evaluate the efficiency for thermo-ablation with microwave and radiofrequency on patients with malignant liver tumors. From January 2002 to January 2005, in our Center of General Surgery and Liver Transplantation in 53 patients 70 sessions of thermoablation were carried out. The mean age was 58 years (25-79 years). Sex ratio men: women was 1.8 (34:19). The diagnosis was hepatocarcinoma in 38 patients (72%), liver metastases from colorectal cancer in 9 (17%) and from non-colorectal cancer (6-11%). The most tumors were single (36-68%). The mean diameter was 39.5 mm (9-94 mm). Percutaneous approach was used in 14 interventions (20%), laparoscopic in 2 (3%) and open approach in 54 cases (77%). We performed 54 sessions of microwave ablation in 42 patients and 8 sessions of radiofrequency ablation in 5 patients. Both methods were applied in 6 patients during 8 sessions. Tumor ablation was done together with liver resection in 10 patients (19%) and resections of other organs in other 8 patients (15%). Morbidity was 12%. The encountered complications were ascites, right pleural effusion and liver abscesses. There was no death. Total and partial necrosis was observed in 27, respectively 20 patients. Local recurrence occurred in one patient but distal liver recurrences were diagnosed in 13 patients. After thermoablation for partial necrosis, local or distal recurrences patients received arterial chemoembolization (5), systemic chemotherapy (23), liver resection (1) and transplantation (1). The mean survival at 1 year and 3 years was 77% and respectively 38%. Microwave or radiofrequency ablation is a simple treatment method, with proved efficiency and minimal risks whose main indication is unresectable tumor.
我们研究的目的是评估微波和射频热消融治疗恶性肝肿瘤患者的疗效。2002年1月至2005年1月，在我们的普通外科和肝移植中心，对53例患者进行了70次热消融治疗。平均年龄为58岁（25 - 79岁）。男女比例为1.8（34:19）。诊断为肝癌的患者有38例（72%），结直肠癌肝转移患者9例（17%），非结直肠癌肝转移患者6例（11%）。大多数肿瘤为单发（68%）。平均直径为39.5毫米（9 - 94毫米）。14次干预采用经皮途径（20%），2次采用腹腔镜途径（3%），54例采用开放途径（77%）。我们对42例患者进行了54次微波消融，对5例患者进行了8次射频消融。6例患者在8次治疗中同时应用了两种方法。10例患者（19%）在肿瘤消融的同时进行了肝切除，另外8例患者（15%）进行了其他器官切除。发病率为12%。出现的并发症有腹水、右侧胸腔积液和肝脓肿。无死亡病例。分别在27例和20例患者中观察到完全坏死和部分坏死。1例患者出现局部复发，但13例患者被诊断为肝远处复发。部分坏死患者热消融后，局部或远处复发的患者接受了动脉化疗栓塞（5例）、全身化疗（23例）、肝切除（1例）和肝移植（1例）。1年和3年的平均生存率分别为77%和38%。微波或射频消融是一种简单的治疗方法，疗效已得到证实且风险极小，其主要适应证为不可切除的肿瘤。
