胸腔镜下经膈肌切开法对肝顶部肝表面肿瘤进行局部消融
Thoracoscopic local ablation with diaphragmatic incision method for liver surface tumor in the hepatic dome.
作者信息
Ishiko Takatoshi, Beppu Toru, Chikamoto Akira, Imai Katunori, Okabe Hirohisa, Hayashi Hiromitu, Nitta Hidetoshi, Baba Hideo
机构信息
Department of Gastroenterological Surgery, Graduate School of Faculty of Life Science, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
出版信息
Surg Laparosc Endosc Percutan Tech. 2013 Aug;23(4):415-8. doi: 10.1097/SLE.0b013e31828e3bba.
PURPOSE
To assess the feasibility and effectiveness of thoracoscopic local ablation therapy with diaphragmatic incision method.
BACKGROUND
Liver tumor in the hepatic dome limits the approach method of ablation. These lesions are accessible through a transdiaphragm, and incision of diaphragm by thoracoscopic surgery might be a valuable option.
PATIENTS AND METHODS
Between July 1995 and December 2011, 59 patients with a tumor in the hepatic dome were indicated for thoracoscopic local ablation therapy. The diaphragm above tumor was incised and tumors were ablated thoracoscopically.
RESULTS
The mean operating time and blood loss was 222 minutes and 33.8 g, respectively. There was no postoperative mortality, and 7 patients with complications recovered successfully. The 5-year overall survival (OS) rate for hepatocellular carcinoma was 51.0%. Local recurrence was suspected in 2 cases.
CONCLUSIONS
Thoracoscopic ablation by incision of the diaphragm represents a feasible approach for the tumor in the hepatic dome with acceptable long-term outcomes.
目的
评估经膈切开法胸腔镜局部消融治疗的可行性和有效性。
背景
肝顶部的肝肿瘤限制了消融的入路方法。这些病变可通过经膈途径到达，胸腔镜手术切开膈肌可能是一种有价值的选择。
患者和方法
1995年7月至2011年12月，59例肝顶部肿瘤患者接受胸腔镜局部消融治疗。切开肿瘤上方的膈肌，通过胸腔镜对肿瘤进行消融。
结果
平均手术时间和失血量分别为222分钟和33.8克。无术后死亡病例，7例并发症患者成功康复。肝细胞癌的5年总生存率为51.0%。怀疑2例有局部复发。
结论
经膈切开胸腔镜消融术是治疗肝顶部肿瘤的一种可行方法，长期效果可接受。
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