Seifert J K, Junginger T, Morris D L
University of New South Wales, Department of Surgery, St George Hospital, Kogarah, Sydney, Australia.
J R Coll Surg Edinb. 1998 Jun;43(3):141-54.
Published results of hepatic cryotherapy are now available for almost 900 patients. Its safety is well established and its clinical role in treating patients with unresectable hepatoma or liver metastases from colorectal carcinoma is well supported by tumour marker and survival data; the results in the treatment of neuroendocrine liver metastases are promising. Its role as an alternative to liver resection is not yet well supported by long-term data. Although different adjuvant treatment protocols have been used following the cryotherapy of colorectal liver metastases, the effect of adjuvant treatment on recurrence or survival has not been assessed in prospective studies. Laparoscopic hepatic cryotherapy is feasible in selected patients with suitable tumour locations. However, the proportion of patients who might be usefully treated with this technique is not yet well established. The mechanisms of tissue destruction by freezing are reviewed.
目前已有近900例患者肝脏冷冻治疗的公开结果。其安全性已得到充分证实，肿瘤标志物和生存数据有力支持了其在治疗无法切除的肝癌或结直肠癌肝转移患者中的临床作用；在治疗神经内分泌肝转移方面的结果很有前景。长期数据尚未充分支持其作为肝切除替代方法的作用。尽管在结直肠癌肝转移冷冻治疗后采用了不同的辅助治疗方案，但前瞻性研究尚未评估辅助治疗对复发或生存的影响。腹腔镜肝脏冷冻治疗对选定的肿瘤位置合适的患者是可行的。然而，可能通过该技术有效治疗的患者比例尚未明确。本文综述了冷冻导致组织破坏的机制。
