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国际临床研究杂志

International Journal of Clinical Research

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International Journal of Clinical Research. 2022; 6: (9) ; 10.12208/j.ijcr.20220430 .

The study on treatment approach of radiofrequency ablation in liver cancer patents(a report of 1284 cases)
肝癌射频消融手术途径探讨(附1284例报告)

作者: 刘小方, 张桐*, 张翠生, 唐锟, 张卫国, 徐刚, 刘文龙, 陈彬

青岛大学附属烟台毓璜顶医院肝胆外科 山东烟台

*通讯作者: 张桐,单位:青岛大学附属烟台毓璜顶医院肝胆外科 山东烟台;

引用本文: 刘小方, 张桐, 张翠生, 唐锟, 张卫国, 徐刚, 刘文龙, 陈彬 肝癌射频消融手术途径探讨(附1284例报告)[J]. 国际临床研究杂志, 2022; 6: (9) : 7-12.
Published: 2022/11/23 18:23:29

摘要

目的 探讨肝癌射频消融治疗的手术途径。方法 对烟台毓璜顶医院肝胆外科2015年1月至2020年11月共计1284例肝癌射频消融手术进行分析、总结,按手术途径分为经皮、腹腔镜和开腹手术三组,对手术时间、术中出血量、住院时间、术后肝功能情况、术后甲胎蛋白变化、手术相关并发症情况进行对比研究;统计学分析采用SPSS 20.0。结果 门诊随访平均44±32个月,三种途径在术后肝功能变化(P>0.05)、手术相关并发症(P>0.05)、肿瘤复发(P>0.05)方面差异无统计学意义,且术后甲胎蛋白水平均显著下降,无手术死亡病例,但经皮消融手术时间(t=34.312,P<0.05)、住院时间(t=14.608,P<0.05)较腹腔镜和开腹手术显著缩短。结论 经皮、腹腔镜和开腹手术行射频消融治疗肝癌均安全有效,且经皮消融手术时间更短,应根据患者肿瘤具体位置采用个体化方案选择手术途径。

关键词: 肝癌;射频消融;手术途径;个体化

Abstract

Objective: To explore the surgical approach of radiofrequency ablation for hepatocellular carcinoma.
Methods A total of 1284 patients with hepatocellular carcinoma undergoing radiofrequency ablation in department of Hepatobiliary Surgery of Yuhuangding Hospital of Yantai from January 2015 to November 2020 were analyzed and summarized. They were divided into percutaneous, laparoscopic and open surgery groups according to surgical approaches. The operative time, intraoperative blood loss, length of hospital stay, postoperative liver function, postoperative AFP changes, and surgical complications were compared. SPSS20.0 was used for statistical analysis.
Results The average follow-up was 44±32 months. There were no significant differences in postoperative liver function changes (P>0.05), surgery-related complications(P>0.05) and tumor recurrence(P>0.05) among the three approaches. The level of AFP decreased significantly after operation, and there were no surgical deaths in three groups. However, the duration of percutaneous ablation (t=34.312, P<0.05) and length of hospital stay (t=14.608, P<0.05) were significantly shorter than those of laparoscopic and open surgery.
Conclusion   Percutaneous, laparoscopic and open radiofrequency ablation for hepatocellular carcinoma are safe and effective, and the time of percutaneous ablation is shorter, so the surgical approach should be selected according to the specific location of the patient's tumor.

Key words: Liver cancer; Radiofrequency ablation; Treatment approach; Individualized

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