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不可切除的原发性和继发性肝肿瘤的射频消融:88例患者的结果

Radiofrequency-ablation of unresectable primary and secondary liver tumors: results in 88 patients.

作者信息

Hildebrand Philipp, Kleemann Markus, Roblick Uwe J, Mirow Lutz, Birth Matthias, Leibecke Thorsten, Bruch Hans-Peter

机构信息

Department of Surgery, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, D-23538, Luebeck, Germany.

出版信息

Langenbecks Arch Surg. 2006 Apr;391(2):118-23. doi: 10.1007/s00423-006-0024-x. Epub 2006 Mar 25.

Abstract

BACKGROUND AND AIMS

Radiofrequency-ablation (RFA) is increasingly used for destruction of unresectable primary and secondary liver tumors. We report our experience in the use of RFA for the management of unresectable hepatic malignancies.

PATIENTS AND METHODS

Between February 2000 and December 2004 we have undertaken 120 RFA procedures to ablate 426 unresectable primary or metastatic liver tumors in 88 patients. RFA was performed via laparotomy (n=68), laparoscopy (n=9) or a percutaneous approach (n=43). Primary liver cancer was treated in seven patients (8%) and metastatic liver tumors were treated in 81 patients (92%). All patients were followed to assess complications, treatment response and recurrence of malignant disease.

RESULTS

Procedure-related complication rate was low (3.4%). During a mean follow-up of 21.2 months, 15 patients had local tumor progression (17%), 21 patients (23.9%) had new malignant disease and 27 patients (30.7%) died from intervention-unrelated complications of their malignant disease. Additional liver lesions were identified in 27 (35%) of 77 cases by intraoperative ultrasound. Thirty-six patients received simultaneous resection and RFA.

CONCLUSION

RFA is a safe, well-tolerated and effective treatment for patients with unresectable primary and secondary liver malignancies.

摘要

背景与目的

射频消融术(RFA)越来越多地用于不可切除的原发性和继发性肝肿瘤的毁损。我们报告我们使用RFA治疗不可切除肝恶性肿瘤的经验。

患者与方法

2000年2月至2004年12月期间,我们对88例患者的426个不可切除的原发性或转移性肝肿瘤进行了120次RFA手术。RFA通过开腹手术(n = 68)、腹腔镜手术(n = 9)或经皮途径(n = 43)进行。7例患者(8%)治疗原发性肝癌,81例患者(92%)治疗转移性肝肿瘤。对所有患者进行随访,以评估并发症、治疗反应和恶性疾病复发情况。

结果

与手术相关的并发症发生率较低(3.4%)。在平均21.2个月的随访期间,15例患者出现局部肿瘤进展(17%),21例患者(23.9%)出现新的恶性疾病,27例患者(30.7%)死于其恶性疾病的与干预无关的并发症。术中超声在77例中的27例(35%)发现了额外的肝脏病变。36例患者同时接受了切除和RFA。

结论

RFA是治疗不可切除的原发性和继发性肝恶性肿瘤患者的一种安全、耐受性良好且有效的治疗方法。

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