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手术肝切除与超声引导下射频消融治疗结直肠癌肝转移:我们该如何选择?

Surgical hepatic resection vs. ultrasonographic guided radiofrequency ablation in colorectal liver metastases: what should we choose?

作者信息

Ungureanu Bogdan S, Sandulescu Larisa, Şurlin Valeriu, Spârchez Zeno, Săftoiu Adrian

机构信息

Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy, Craiova, Romania.

Surgery Department, University of Medicine and Pharmacy, Craiova, Romania.

出版信息

Med Ultrason. 2014 Jun;16(2):145-51. doi: 10.11152/mu.201.3.2066.162.bsu1.

Abstract

Clinical evolution of the colorectal carcinoma occurs in up to 60% with colorectal liver metastases (CRLM). Although hepatic resection is considered to be the golden standard in CRLM, novel less invasive techniques have emerged, of which radiofrequency ablation has received a high credibility. When tumors are not eligible for surgery, guided radiofrequency ablation is considered an alternative. This method is appropriate when there are no more than 5 lesions with a diameter of less than 3 cm. While open surgery guarantees a more precise tumor excision, the effectiveness of ablation must be evaluated either by contrast-enhanced computer tomography, magnetic resonance, or ultrasound. This paper aim to review the current standings in radiofrequency ablation for CRLM and to compare the technique with surgical resection in order to find which one is the best treatment option.

摘要

高达60%的结直肠癌肝转移(CRLM)患者会出现临床病情进展。尽管肝切除术被认为是CRLM的金标准,但新的微创技术已经出现,其中射频消融术已获得高度认可。当肿瘤不适合手术时,引导式射频消融术被视为一种替代方法。当存在不超过5个直径小于3厘米的病灶时,这种方法是合适的。虽然开放手术能保证更精确的肿瘤切除,但消融的有效性必须通过对比增强计算机断层扫描、磁共振成像或超声来评估。本文旨在综述CRLM射频消融的现状,并将该技术与手术切除进行比较,以找出哪种是最佳治疗选择。

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