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214例微波组织凝固肝切除术的临床结果

Clinical outcome of 214 liver resections using microwave tissue coagulation.

作者信息

Satoi Sohei, Kamiyama Yasuo, Matsui Yoichi, Kitade Hiroaki, Kaibori Masaki, Yamamoto Hidekazu, Yanagimoto Hiroaki, Takai Soichiro, Kwon A-Hon

机构信息

Department of Surgery, Kansai Medical University, Osaka, Japan.

出版信息

Hepatogastroenterology. 2005 Jul-Aug;52(64):1180-5.

Abstract

BACKGROUND/AIMS: Liver resection is the most effective form of treatment for patients with hepatocellular carcinoma. The use of a microwave tissue coagulator has been reported to enable limited liver resections for the patients with poor hepatic reserve. Herein, we report the clinical outcome of 214 patients with HCC who underwent non-anatomical liver resection using MTC in accordance with the tumor size.

METHODOLOGY

A consecutive series of 214 patients who underwent liver resections using MTC were observed over a 10-year study period. The clinical characteristics of patients were evaluated. The operative mortality and morbidity, overall patient survival and disease-free survival were calculated.

RESULTS

Seventy-two percent of patients suffered from type C hepatitis and 47% of patients had pathologically proven liver cirrhosis. The overall patient survival rates were 91, 72, and 58% at 1, 3 and 5 years, respectively. Disease-free survival rates were 74, 46, and 28% at 1, 3 and 5 years, respectively. Postoperative morbidity was 36% and hospital mortality was 2.8%. Complications in most patients were well controlled.

CONCLUSIONS

Non-anatomical liver resections using MTC, in accordance with tumor sizes, can be achieved safely with acceptable results and without the need to use special techniques.

摘要

背景/目的:肝切除术是肝细胞癌患者最有效的治疗方式。据报道,使用微波组织凝固器能够对肝储备功能差的患者进行局限性肝切除术。在此,我们报告214例肝细胞癌患者根据肿瘤大小采用微波组织凝固器进行非解剖性肝切除的临床结果。

方法

在一项为期10年的研究期间,对连续214例行微波组织凝固器肝切除术的患者进行观察。评估患者的临床特征。计算手术死亡率和发病率、患者总体生存率和无病生存率。

结果

72%的患者患有丙型肝炎,47%的患者经病理证实有肝硬化。患者1年、3年和5年的总体生存率分别为91%、72%和58%。1年、3年和5年的无病生存率分别为74%、46%和28%。术后发病率为36%,医院死亡率为2.8%。大多数患者的并发症得到了良好控制。

结论

根据肿瘤大小采用微波组织凝固器进行非解剖性肝切除可以安全实施,结果可接受,且无需使用特殊技术。

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