Li Huan-Song, Zhang Xuan-Feng, Fu Jun, Yuan Bo
Department of Hepatobiliary Pancreatic Center, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China.
World J Gastrointest Surg. 2025 Mar 27;17(3):101786. doi: 10.4240/wjgs.v17.i3.101786.
In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation (MWA) and laparoscopic hepatectomy (LH), which are both important treatment modalities for liver neoplasms, have been limited in patients diagnosed with primary small liver cancer (PSLC).
To compare and analyze the clinical efficacy of liver tumor MWA and LH for PSLC.
This study retrospectively analyzed the medical records of 123 patients with PSLC admitted to Xuzhou Central Hospital from January 2015 to November 2022 and categorized them based on treatment modalities into the LH and MWA groups. The LH group, consisting of 61 cases, received LH, and the MWA group, which included 62 cases, underwent liver tumor MWA. Basic data and various perioperative indicators were compared between the two groups, including changes in liver function indicators [alanine aminotransferase (ALT), glutamic aminotransferase (AST), and total bilirubin (TBIL)] pre- and post-treatment, and efficacy and postoperative complications were analyzed.
No statistically significant difference was observed between the two groups in terms of age, gender, tumor diameter, liver function Child-Pugh classification and number of tumors, body mass index, and educational status ( > 0.05). The overall effective rate was higher in the MWA group than in the LH group (98.39% 88.52%) ( = 4.918, = 0.027). The MWA group exhibited less operation time, intraoperative bleeding, defecation time, and hospital stay than the LH group ( < 0.05). No difference was found in liver function indicators between the two groups pre-treatment ( > 0.05), and ALT, AST, and TBIL levels decreased in both groups post-treatment, with the MWA group demonstrating lower levels ( < 0.05). The MWA and LH groups exhibited postoperative complication rates of 4.84% and 19.67%, respectively, with statistically significant differences between the two groups ( = 0.012, = 6.318).
MWA is more effective in treating PSLC, and it promotes faster postoperative recovery for patients, and more security improves liver function and reduces postoperative complications compared to LH.
肝肿瘤微波消融(MWA)和腹腔镜肝切除术(LH)都是肝脏肿瘤的重要治疗方式,但针对原发性小肝癌(PSLC)患者的临床疗效深入对比研究有限。
比较并分析PSLC患者肝肿瘤MWA与LH的临床疗效。
本研究回顾性分析了2015年1月至2022年11月在徐州中心医院收治的123例PSLC患者的病历资料,根据治疗方式将其分为LH组和MWA组。LH组61例接受LH治疗,MWA组62例接受肝肿瘤MWA治疗。比较两组的基础数据和各项围手术期指标,包括治疗前后肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素(TBIL)]的变化,并分析疗效及术后并发症。
两组在年龄、性别、肿瘤直径、肝功能Child-Pugh分级、肿瘤数量、体重指数和受教育程度方面差异无统计学意义(>0.05)。MWA组的总有效率高于LH组(98.39%对88.52%)(=4.918,=0.027)。MWA组的手术时间、术中出血量、排便时间和住院时间均少于LH组(<0.05)。两组治疗前肝功能指标差异无统计学意义(>0.05),两组治疗后ALT、AST和TBIL水平均下降,且MWA组较低(<0.05)。MWA组和LH组的术后并发症发生率分别为4.84%和19.67%,两组差异有统计学意义(=0.012,=6.318)。
MWA治疗PSLC更有效,能促进患者术后更快恢复,安全性更高,与LH相比可改善肝功能并减少术后并发症。