Xu Zhifeng, Yang Zhangwei, Pan Jianghua, Hu Yiren
Department of General Surgery, Wenzhou People's Hospital, Wenzhou, China.
Wideochir Inne Tech Maloinwazyjne. 2018 Mar;13(1):9-16. doi: 10.5114/wiitm.2018.72730. Epub 2018 Jan 22.
Liver cancer is one of the most common malignancies of the digestive system. Minimally invasive ablation procedures have become one of the major means for treating unresectable multifocal liver cancer and have been extensively applied in primary and metastatic liver cancer treatment. Laparoscopic B-ultrasound-guided microwave ablation is an example of the progress made in this field.
To analyze and summarize the results of and experience with laparoscopic B-ultrasound-guided microwave ablation for multifocal primary liver cancer; moreover, the ablation effects were compared between tumors of different sizes.
Laparoscope-guided needle ablation was conducted on 84 lesions from 32 patients with primary liver cancer based on tumor size, quantity, and location. Moreover, the perioperative data, ablation effects according to tumor size, and long-term follow-up results were analyzed.
Among the 84 nodules treated via microwave ablation, tumors measuring ≤ 3 cm demonstrated complete ablation upon imaging analysis conducted 1 month after surgery. Moreover, 5 of the tumors measuring > 3 cm demonstrated incomplete ablation. In these cases, a second procedure was performed, until imaging studies confirmed that complete ablation was achieved.
Laparoscopic microwave ablation allows for precise puncture positioning, an effective ablation range, and safe and feasible surgery, which is especially suitable for liver tumors located in sites difficult to access.
肝癌是消化系统最常见的恶性肿瘤之一。微创消融手术已成为治疗不可切除的多灶性肝癌的主要手段之一，并已广泛应用于原发性和转移性肝癌的治疗。腹腔镜B超引导下微波消融就是该领域取得的进展之一。
分析和总结腹腔镜B超引导下微波消融治疗多灶性原发性肝癌的结果和经验；此外，比较不同大小肿瘤的消融效果。
根据肿瘤大小、数量和位置，对32例原发性肝癌患者的84个病灶进行腹腔镜引导下针消融。此外，分析围手术期数据、根据肿瘤大小的消融效果以及长期随访结果。
在通过微波消融治疗的84个结节中，直径≤3 cm的肿瘤在术后1个月进行的影像学分析显示完全消融。此外，5个直径>3 cm的肿瘤显示消融不完全。在这些情况下，进行了第二次手术，直到影像学研究证实实现了完全消融。
腹腔镜微波消融可实现精确穿刺定位、有效的消融范围以及安全可行的手术，特别适用于位于难以到达部位的肝脏肿瘤。
