Saitsu H, Nakayama T
Second Department of Surgery, School of Medicine, Kurume University.
Nihon Rinsho. 1993 Apr;51(4):1102-7.
We performed microwave coagulo-necrotic therapy (MCN), a new surgical treatment for hepatocellular carcinoma (HCC) under laparotomy on 41 cases and under laparoscopy on 5 cases for a total of 46 cases (70 cancer nodules). The indications for MCN include: 1) cases in which an early recurrence is judged as likely to occur. For example, multinodular cases, or intrahepatic metastasis (im1-3) 25 cases (54.3%), 9 cases (19.6%) in which multiple adenomatous hyperplasia was detected, VP2 1 case (2.2%). 2) 7 cases (15.2%) in which if hepatectomy is conducted, there is a high risk of postoperative liver failure, or cases in which it is judged postoperative management will be very difficult. In only 4 cases was it because the patients requested laparoscopic MCN (lapa. MCN). Also, the tumor size was less than 15 mm in 4 cases, 16 to 20 mm in 6 cases, 21-30 mm in 21 cases, 31-50 mm in 6 cases, and larger than 51 mm in 9 cases (maximum 90 x 65 mm). Only 1 case who died on the 17th postoperative day due to sudden ventricular arrhythmia, and 3 cases who died cancer death at 1 year 6 months, 2 year 2 months, and 4 years 1 months after the operation for a total of 4 cases, so that 42 patients have survived 4 years and 3 months as of this writing. Thus MCN was in no way inferior to hepatectomy.
我们对41例患者进行了剖腹手术下的微波凝固坏死疗法(MCN),这是一种针对肝细胞癌(HCC)的新型外科治疗方法,对5例患者进行了腹腔镜下的该治疗,共计46例(70个癌结节)。MCN的适应证包括:1)判断可能发生早期复发的病例。例如,多结节病例或肝内转移(im1 - 3)25例(54.3%),检测到多发腺瘤样增生的9例(19.6%),VP2 1例(2.2%)。2)7例(15.2%)如果进行肝切除术,术后肝衰竭风险高,或判断术后管理将非常困难的病例。仅4例是因为患者要求进行腹腔镜MCN(lapa. MCN)。此外,肿瘤大小小于15mm的有4例,16至20mm的有6例,21 - 30mm的有21例,31 - 50mm的有6例,大于51mm的有9例(最大90×65mm)。仅1例患者术后第17天因突发性室性心律失常死亡,3例患者分别在术后1年6个月、2年2个月和4年1个月死于癌症,共计4例死亡,截至撰写本文时,42例患者已存活4年3个月。因此,MCN绝不逊色于肝切除术。