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用于腹腔镜微波热消融治疗肝脏恶性肿瘤的规划软件的首次临床应用。

The first clinical application of planning software for laparoscopic microwave thermosphere ablation of malignant liver tumours.

作者信息

Berber Eren

机构信息

Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, OH, USA.

出版信息

HPB (Oxford). 2015 Jul;17(7):632-6. doi: 10.1111/hpb.12423. Epub 2015 May 16.

Abstract

BACKGROUND

Liver tumour ablation is an operator-dependent procedure. The determination of the optimum needle trajectory and correct ablation parameters could be challenging. The aim of this study was to report the utility of a new, procedure planning software for microwave ablation (MWA) of liver tumours.

METHODS

This was a feasibility study in a pilot group of five patients with nine metastatic liver tumours who underwent laparoscopic MWA. Pre-operatively, parameters predicting the desired ablation zones were calculated for each tumour. Intra-operatively, this planning strategy was followed for both antenna placement and energy application. Post-operative 2-week computed tomography (CT) scans were performed to evaluate complete tumour destruction.

RESULTS

The patients had an average of two tumours (range 1-4), measuring 1.9 ± 0.4 cm (range 0.9-4.4 cm). The ablation time was 7.1 ± 1.3 min (range 2.5-10 min) at 100W. There were no complications or mortality. The patients were discharged home on post-operative day (POD) 1. At 2-week CT scans, there were no residual tumours, with a complete ablation demonstrated in all lesions.

CONCLUSIONS

This study describes and validates pre-treatment planning software for MWA of liver tumours. This software was found useful to determine precisely the ablation parameters and needle placement to create a predicted zone of ablation.

摘要

背景

肝脏肿瘤消融是一种依赖操作者的操作。确定最佳针道轨迹和正确的消融参数可能具有挑战性。本研究的目的是报告一种用于肝脏肿瘤微波消融(MWA)的新型手术规划软件的实用性。

方法

这是一项针对5例患有9个肝转移瘤的患者的试点组进行的可行性研究,这些患者接受了腹腔镜MWA。术前,为每个肿瘤计算预测所需消融区域的参数。术中,在天线放置和能量应用方面均遵循该规划策略。术后2周进行计算机断层扫描(CT)以评估肿瘤是否被完全破坏。

结果

患者平均有两个肿瘤(范围1 - 4个),大小为1.9±0.4厘米(范围0.9 - 4.4厘米)。在100W功率下,消融时间为7.1±1.3分钟(范围2.5 - 10分钟)。无并发症或死亡。患者在术后第1天出院回家。术后2周CT扫描显示无残留肿瘤,所有病变均实现完全消融。

结论

本研究描述并验证了用于肝脏肿瘤MWA的术前规划软件。发现该软件有助于精确确定消融参数和针的放置,以创建预测的消融区域。

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