Ross W B, Horton M, Bertolino P, Morris D L
University of New South Wales, Department of Surgery, Australia.
HPB Surg. 1995 Jun;8(3):167-73. doi: 10.1155/1995/93283.
The use of cryotherapy for the treatment of some unresectable liver tumours has been clearly established as a therapeutic option. Intra-operative ultrasound has enhanced the process by enabling the surgeon to identify hepatic lesions and to allow visualisation of the freezing process to ensure that the cryolesion will include the tumour mass. The purpose of this paper is to provide a practical guide to surgeons who wish to perform cryotherapy of liver tumours. Patient selection and anaesthetic considerations are important. The surgeon should be able to deal with the complications of cryotherapy, particularly the intra-operative haemorrhage which may arise from cracking of the hepatic parenchyma as the iceball thaws. Follow-up is based on tumour marker assay and imaging of the liver and repeat cryotherapy can be considered for selected cases.
冷冻疗法用于治疗某些无法切除的肝肿瘤已被明确确立为一种治疗选择。术中超声通过使外科医生能够识别肝脏病变并可视化冷冻过程，以确保冷冻损伤包括肿瘤块，从而改进了这一过程。本文的目的是为希望进行肝肿瘤冷冻治疗的外科医生提供一份实用指南。患者选择和麻醉注意事项很重要。外科医生应能够处理冷冻疗法的并发症，特别是术中出血，这可能是由于冰球解冻时肝实质破裂所致。随访基于肿瘤标志物检测和肝脏成像，对于选定的病例可考虑重复冷冻治疗。
