Jagad Rajan B, Koshariya Mahim, Kawamoto Jun, Papastratis P, Kefalourous H, Patris V, Porfiris T, Gevrielidis Pascailis, Tzouma Christina, Lygidakis N J
Department of Surgical Oncology, Athens Medical Center, Psychiko, Athens, Greece.
Hepatogastroenterology. 2008 Jan-Feb;55(81):27-32.
BACKGROUND/AIMS: Microwave ablation is the most recent development in the field of tumor ablation and is a well established and safe local ablative method available for liver tumors (both primary and secondary tumors). The technique allows for flexible approaches to treatment, including percutaneous, laparoscopic, and open surgical access. Laparoscopic technique has the advantages of accurate tumor staging, better tolerability and low cost. It can be performed in tumors which are close to the vital organs. The aim of this study was to evaluate the feasibility and safety of laparoscopic microwave ablation of liver tumors.
During January 2001 to December 2005, 57 patients with liver tumors were treated with laparoscopic microwave ablation in the department of Surgical Oncology. There were 34 male and 23 female patients. Out of 57 patients, 11 patients had hepatocellular carcinoma and 46 patients had secondaries in the liver. The most common source of secondaries was colorectal cancers. Laparoscopic microwave ablation of tumors was performed in these patients.
During the study period, 57 patients with no evidence of extrahepatic disease underwent laparoscopic microwave ablation of unresectable hepatic tumors. No major intraoperative complications occurred. Postoperatively all the patients did well. Four patients developed liver abscess at the ablation area. Two patients required percutaneous aspiration of the liver abscess. No other major complications occurred. Follow-up CT scan shows complete necrosis of the tumors. Patients were followed-up at regular intervals.
Laparoscopic microwave ablation is a feasible and safe alternative to open microwave ablation of the liver tumors. It carries all the advantage of minimal invasive surgery. In experienced hands, microwave ablation using laparoscopic technique can be done safely and effectively.
背景/目的:微波消融是肿瘤消融领域的最新进展,是一种成熟且安全的用于肝脏肿瘤(原发性和继发性肿瘤)的局部消融方法。该技术允许采用灵活的治疗途径,包括经皮、腹腔镜和开放手术入路。腹腔镜技术具有准确肿瘤分期、耐受性好和成本低的优点。它可用于靠近重要器官的肿瘤。本研究的目的是评估腹腔镜微波消融肝脏肿瘤的可行性和安全性。
2001年1月至2005年12月期间,外科肿瘤学部门对57例肝脏肿瘤患者进行了腹腔镜微波消融治疗。其中男性34例,女性23例。57例患者中,11例患有肝细胞癌,46例肝脏有继发性肿瘤。最常见的继发性肿瘤来源是结直肠癌。对这些患者进行了腹腔镜肿瘤微波消融治疗。
在研究期间,57例无肝外疾病证据的患者接受了腹腔镜微波消融不可切除的肝脏肿瘤。术中未发生重大并发症。术后所有患者情况良好。4例患者在消融区域出现肝脓肿。2例患者需要经皮抽吸肝脓肿。未发生其他重大并发症。随访CT扫描显示肿瘤完全坏死。对患者进行定期随访。
腹腔镜微波消融是肝脏肿瘤开放微波消融的一种可行且安全的替代方法。它具有微创手术的所有优点。在经验丰富的医生手中,使用腹腔镜技术进行微波消融可以安全有效地完成。