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超声引导下经皮微波消融治疗胆囊旁肝恶性肿瘤

Ultrasound-guided percutaneous microwave ablation for hepatic malignancy adjacent to the gallbladder.

作者信息

Li Meng, Yu Xiaoling, Liang Ping, Dong Baowei, Liu Fangyi

机构信息

a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China and.

b Department of Ultrasound , Chinese PLA 302 Hospital , Beijing , China.

出版信息

Int J Hyperthermia. 2015;31(6):579-87. doi: 10.3109/02656736.2015.1014869. Epub 2015 Jun 22.

Abstract

PURPOSE

The study was performed to assess the safety and efficacy of ultrasound (US)-guided percutaneous microwave (MW) ablation for hepatic malignancy adjacent to the gallbladder.

MATERIALS AND METHODS

From January 2011 to December 2013, 49 patients with 51 hepatic tumours adjacent to the gallbladder who underwent US-guided percutaneous MW ablation were included in the study group. A total of 106 patients with 117 hepatic tumours not adjacent to the gallbladder who underwent US-guided percutaneous MW ablation were included in the control group. In the study group the temperature of marginal ablation tissue proximal to the gallbladder was monitored and controlled at 45-54 °C for 5-10 min during the ablation. Ethanol (4.5-13 mL) was injected into the marginal tissue in 27 of 51 tumours of the study group. We compared the results of ablation between the two groups.

RESULTS

All patients were successfully treated. A total of 47 of 51 tumours in the study group (92.2%) and 110 of 117 tumours in the control group (94.0%) achieved complete ablation (p = 0.93). Local tumour progression was found in nine (17.6%) tumours in the study group and 15 (12.8%) tumours in the control group during follow-up after MW ablation (p = 0.41). No peri-procedural major complications occurred in either group.

CONCLUSIONS

Under strict temperature monitoring, US-guided percutaneous MW ablation assisted with ethanol injection appears to be safe and can achieve a high rate of complete ablation for the treatment of hepatic malignant tumours adjacent to the gallbladder.

摘要

目的

本研究旨在评估超声(US)引导下经皮微波(MW)消融治疗胆囊旁肝恶性肿瘤的安全性和有效性。

材料与方法

2011年1月至2013年12月,研究组纳入49例患有51个胆囊旁肝肿瘤并接受超声引导下经皮微波消融的患者。对照组纳入106例患有117个非胆囊旁肝肿瘤并接受超声引导下经皮微波消融的患者。研究组在消融过程中,对胆囊近端边缘消融组织的温度进行监测,并控制在45-54°C持续5-10分钟。研究组51个肿瘤中的27个,在边缘组织中注射了乙醇(4.5-13 mL)。我们比较了两组的消融结果。

结果

所有患者均成功治疗。研究组51个肿瘤中的47个(92.2%)和对照组117个肿瘤中的110个(94.0%)实现了完全消融(p = 0.93)。微波消融术后随访期间,研究组9个(17.6%)肿瘤和对照组15个(12.8%)肿瘤出现局部肿瘤进展(p = 0.41)。两组均未发生围手术期严重并发症。

结论

在严格的温度监测下,超声引导下经皮微波消融联合乙醇注射似乎是安全的,并且可以实现较高的完全消融率,用于治疗胆囊旁肝恶性肿瘤。

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