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腹腔镜下微波热消融治疗肝脏恶性肿瘤:53例分析

Laparoscopic microwave thermosphere ablation of malignant liver tumors: An analysis of 53 cases.

作者信息

Zaidi Nisar, Okoh Alexis, Yigitbas Hakan, Yazici Pinar, Ali Noaman, Berber Eren

机构信息

Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio.

出版信息

J Surg Oncol. 2016 Feb;113(2):130-4. doi: 10.1002/jso.24127. Epub 2015 Dec 10.

Abstract

BACKGROUND AND OBJECTIVES

Microwave thermosphere ablation (MTA) is a new technology that is designed to create spherical zones of ablation using a single antenna. The aim of this study is to assess the results of MTA in a large series of patients.

METHODS

This was a prospective study assessing the use of MTA in patients with malignant liver tumors. The procedures were done mostly laparoscopically and ablation zones created were assessed for completeness of tumor response, spherical geometry and recurrence on tri-phasic CT scans done on follow-up.

RESULTS

There were a total of 53 patients with an average of 3 tumors measuring 1.5 cm. Ablations were performed laparoscopically in all but eight patients. Morbidity was 11.3% (n = 6), and mortality zero. On postoperative scans, there was 99.3% tumor destruction. Roundness indices A, B, and transverse were 1.1, 1.0, and 0.9, respectively. At a median follow-up of 4.5 months, incomplete ablation was seen in 1 of 149 lesions treated (0.7%) and local tumor recurrence in 1 lesion (0.7%).

CONCLUSIONS

The results of this series confirm the safety and feasibility of MTA technology. The 99.3% rate of complete tumor ablation and low rate of local recurrence at short-term follow up are promising.

摘要

背景与目的

微波热球消融术(MTA)是一项旨在通过单一天线创建球形消融区的新技术。本研究的目的是评估MTA在大量患者中的应用结果。

方法

这是一项评估MTA在恶性肝肿瘤患者中应用的前瞻性研究。手术大多通过腹腔镜进行,并通过后续的三相CT扫描评估所创建的消融区的肿瘤反应完整性、球形几何形状及复发情况。

结果

共有53例患者,平均有3个肿瘤,直径为1.5厘米。除8例患者外,所有患者均通过腹腔镜进行消融。发病率为11.3%(n = 6),死亡率为零。术后扫描显示肿瘤破坏率为99.3%。圆形度指数A、B和横向分别为1.1、1.0和0.9。在中位随访4.5个月时,149个治疗病灶中有1个(0.7%)出现不完全消融,1个病灶(0.7%)出现局部肿瘤复发。

结论

本系列研究结果证实了MTA技术的安全性和可行性。99.3%的肿瘤完全消融率以及短期随访时较低的局部复发率很有前景。

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