腹腔镜射频消融治疗单个原发性或复发性肝细胞癌（≤3厘米）的临床结果
Clinical outcomes of laparoscopic radiofrequency ablation of single primary or recurrent hepatocellular carcinoma (≤3 cm).
作者信息
Na Byung Gon, Kim Jong Man, Oh Dong Kyu, Lee Kyo-Won, Kang Tae-Wook, Choi Gyu-Seong, Lee Min Woo, Kwon Choon Hyuck David, Lim Hyun Chul, Joh Jae-Won
机构信息
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
Ann Surg Treat Res. 2017 May;92(5):355-360. doi: 10.4174/astr.2017.92.5.355. Epub 2017 Apr 27.
PURPOSE
Percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) has some limitations such as poor sonic window and injury to adjacent organs. The laparoscopic approach has been suggested as an alternative option. The aim of this study was to show the safety and efficacy of laparoscopic RFA for single, small (≤3 cm), and primary or recurrent HCC that is not suitable for percutaneous RFA or surgical resection.
METHODS
We reviewed the cases of 37 patients (32 men and 5 women, mean age 61 ± 8.1 years) who underwent laparoscopic RFA for single, small HCC (≤3 cm) that was unsuitable for percutaneous RFA or surgical resection.
RESULTS
The technical success rate was 94.6% and 34 patients (95%) had no complications. There were no conversions to open RFA and no operative mortality. The primary effectiveness rate 1 month after the procedure was 100%. The overall recurrence rates at 3, 6, 12, and 24 months after the laparoscopic RFA were 8.1%, 14.4%, 25%, and 35.7%, respectively. The local tumor progression rate was 4.2% at 6 months and 8.7% at 9 months.
CONCLUSION
Laparoscopic RFA is a safe and effective treatment for HCC cases that are unsuitable for percutaneous RFA.
目的
经皮射频消融术（RFA）治疗肝细胞癌（HCC）存在一些局限性，如声窗不佳及对邻近器官的损伤。腹腔镜手术已被提议作为一种替代选择。本研究的目的是表明腹腔镜RFA治疗单个、小（≤3 cm）、原发性或复发性HCC且不适合经皮RFA或手术切除的安全性和有效性。
方法
我们回顾了37例患者（32例男性和5例女性，平均年龄61±8.1岁）的病例，这些患者因单个小HCC（≤3 cm）接受了腹腔镜RFA治疗，且该HCC不适合经皮RFA或手术切除。
结果
技术成功率为94.6%，34例患者（95%）无并发症。无一例转为开放RFA，无手术死亡病例。术后1个月的主要有效率为100%。腹腔镜RFA术后3、6、12和24个月的总复发率分别为8.1%、14.4%、25%和35.7%。6个月时局部肿瘤进展率为4.2%，9个月时为8.7%。
结论
对于不适合经皮RFA的HCC病例，腹腔镜RFA是一种安全有效的治疗方法。
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