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肝切除术联合脾脏微波消融治疗肝细胞癌合并脾肿大:一项回顾性研究。

Hepatectomy combined with microwave ablation of the spleen for treatment of hepatocellular carcinoma complicated with splenomegaly: A retrospective study.

作者信息

Han Jian-Bo, Kong Feng-Wei, Ding Hai, Zhang Yu-Feng, Liu Jun-Mao, Wei Qiang, Hu Liang, Zhao Liang, Xu Chuan-Jun, Yi Yong-Xiang

机构信息

Department of Hepatobiliary Surgery, The Second Hospital of Nanjing, Affiliated to Southeast University, Nanjing, Jiangsu 210003, P.R. China.

Department of General Surgery, Xuzhou Infectious Diseases Hospital, Xuzhou, Jiangsu 221004, P.R. China.

出版信息

Mol Clin Oncol. 2017 Feb;6(2):204-208. doi: 10.3892/mco.2016.1111. Epub 2016 Dec 14.

Abstract

The present retrospective study aimed to investigate the mid-term safety and efficacy of hepatectomy combined with microwave ablation of the partial spleen for treatment of liver cancer complicated with hypersplenism. A retrospective analysis was performed on 23 patients who underwent hepatectomy combined with microwave ablation of the partial spleen for liver cancer, complicated with hypersplenism that was secondary to cirrhosis. The splenic and ablated volumes were calculated according to a contrast-enhanced computed tomography scan prior to and 2 weeks after the operation. Complete blood count and liver function tests were examined prior to and following the surgery, and complications and changes in the blood tests were monitored for 6 months. Over this period of investigation, the splenic volume was reduced by a mean value of 34.0%. The levels of serum alanine aminotransferase and aspartate aminotransferase were increased on the first day after the operation (P<0.05), although they recovered to the normal level within 1 week (P<0.05). The total level of bilirubin increased slightly, along with moderately decreased levels of albumin and cholinesterase on the first day, although these changes were not significant compared with the baseline (P>0.05). The white blood cell count was persistently significantly higher compared with the baseline over the course of the 6 months (P>0.05). The platelet count did not increase significantly for the first week after the operation (P>0.05); however, it was revealed to be significantly increased 1 month after the surgery (P<0.05). No significant complications were occurred during the follow-up period. In conclusion, hepatectomy combined with microwave ablation of the spleen was demonstrated to be a safe and effective procedure for patients with liver cancer and hypersplenism in the mid-term.

摘要

本回顾性研究旨在探讨肝切除术联合部分脾脏微波消融治疗肝癌合并脾功能亢进的中期安全性和疗效。对23例行肝切除术联合部分脾脏微波消融治疗肝癌合并肝硬化继发性脾功能亢进的患者进行回顾性分析。根据术前及术后2周的增强CT扫描计算脾脏及消融体积。术前及术后检查血常规和肝功能,并监测6个月的并发症及血液检查变化。在这段研究期间,脾脏体积平均减少了34.0%。术后第1天血清谷丙转氨酶和谷草转氨酶水平升高(P<0.05),但在1周内恢复至正常水平(P<0.05)。总胆红素水平略有升高,白蛋白和胆碱酯酶水平在第1天略有下降,但与基线相比这些变化无统计学意义(P>0.05)。在6个月的随访过程中,白细胞计数持续显著高于基线水平(P>0.05)。术后第1周血小板计数无显著增加(P>0.05);然而,术后1个月血小板计数显著增加(P<0.05)。随访期间未发生明显并发症。总之,肝切除术联合脾脏微波消融术对肝癌合并脾功能亢进患者中期而言是一种安全有效的手术方法。

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