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超声引导经皮微波消融治疗无人工腹水辅助下心下肝癌的可行性和安全性研究。

Feasibility and safety study of ultrasound-guided percutaneous microwave ablation for sub-cardiac liver cancers without artificial ascites assistance.

机构信息

Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong Province, 518033, China.

Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, 518036, China.

出版信息

Br J Radiol. 2024 Nov 1;97(1163):1856-1862. doi: 10.1093/bjr/tqae169.

DOI:10.1093/bjr/tqae169
PMID:39177580
Abstract

OBJECTIVES

To investigate the efficacy and safety of ultrasound (US)-guided microwave ablation (MWA) without artificial ascites (AA) inpatients with sub-cardiac (SC) liver cancers.

METHODS

This retrospective study included patients with the left lobe and caudate lobe of the liver cancer who underwent US-guided MWA in our institute from January 2020 to December 2022. According to whether the target lesion was located ≤5 mm from the pericardium, patients were divided into the SC group and the non-sub-cardiac (NSC) group. In the SC group, AA was not employed during the ablation procedure. The results of technical success, technical efficiency, local tumour progression (LTP), and major complications were recorded.

RESULTS

A total of 79 patients with 87 lesions were enrolled. There were 38 patients with 38 lesions in the SC group and 41 patients with 49 lesions in the NSC group. The median follow-up of all patients was 15 (range, 3-44) months. There was no significant difference in technical success rates (100% vs 100%), technique efficiency rates (100% vs 95.7%), LTP rates (2.63% vs 0%,), and major complication rates (2.63% vs 7.32%) between the SC group and the NSC group (P > .05). No cardiac-related complications occurred.

CONCLUSIONS

US-guided MWA without AA for SC liver cancers was safe and effective.

ADVANCES IN KNOWLEDGE

The clinical prognosis of thermal ablation without AA in the treatment of SC liver cancers is still unclear. The finding of this study provided evidence supporting the efficacy and safety of US-guided MWA without AA for treating this tricky location.

摘要

目的

探讨超声引导下无人工腹水(AA)微波消融(MWA)治疗心下型(SC)肝癌的疗效和安全性。

方法

本回顾性研究纳入 2020 年 1 月至 2022 年 12 月在我院行超声引导下 MWA 治疗的左叶和尾状叶肝癌患者。根据靶病灶是否位于心脏下≤5mm 分为 SC 组和非心下(NSC)组。SC 组消融过程中不使用 AA。记录技术成功率、技术有效率、局部肿瘤进展(LTP)和主要并发症的发生情况。

结果

共纳入 79 例 87 个病灶患者,SC 组 38 例 38 个病灶,NSC 组 41 例 49 个病灶。所有患者中位随访时间为 15(3~44)个月。SC 组和 NSC 组技术成功率(100% vs 100%)、技术有效率(100% vs 95.7%)、LTP 率(2.63% vs 0%)和主要并发症率(2.63% vs 7.32%)差异均无统计学意义(P>0.05)。均未发生与心脏相关的并发症。

结论

超声引导下心下型肝癌无 AA 的 MWA 治疗是安全有效的。

知识进展

目前对于治疗 SC 肝癌无 AA 热消融的临床预后尚不清楚。本研究结果为超声引导下心下型肝癌无 AA 的 MWA 治疗提供了疗效和安全性的证据支持。

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