论文部分内容阅读
Objects:This studyaimedtoinvestigatethesafetyandeffectivenessofirreversibleelectroporationablationforunresectablelarge livercancer. Methods:Wecollectedpatientswithprimarylivercancerdiagnosedbyhistopathologyandcomputedtomography,whowerenot amenabletosurgicalresectionandwhohadapreoperativefunctionalstatusscore≤2.Fourteenpatientswereenrolled:eight withlargehepatocellularcarcinoma(tumordiameter5.1-11.5cm)andsixwithmedianhepatocellularcarcinoma(tumordiameter 3.0-4.1cm).AllpatientsreceivedpercutaneousirreversibleelectroporationablationwithB-ultrasoundandcomputed tomographyguidance.ThepatientsweremonitoredandtreatedinaccordancewiththeInternationalAssociationofRadiation Therapyclassificationcriteriaforevaluatingcomplicationsintheperioperativeperiod.Ablationtimeandtheincidenceof complicationswereassessedbyattest.Post-irreversibleelectroporation,regularcontrast-enhancedcomputerizedtomography scanswereperformedtoinvestigatetheeffectoftumorsize(largevs.median)onirreversibleelectroporationtreatmentefficacy; four-tabledatawasassessedbyaChi-squareχ2test. Results:The14patientscompletedirreversibleelectroporationablationsuccessfully.Inthelargehepatocellularcarcinomagroup, nomajorcomplicationsoccurredintheperioperativeperiod.Minorcomplicationscomprisedbloating,hypokalemia,edema,low whitebloodcellsandbloodclottingabnormalities.Allcomplicationsweremildandimprovedaftersymptomatictreatment.The frequencyofminorcomplicationswasnotsignificantlydifferent(P>0.05)comparedwiththemedianhepatocellularcarcinoma group.Theaveragefollow-uptimewas2.8±2.1monthsandcompleteablationwasachievedin25%(2/8;residual=75%).For themedianhepatocellularcarcinomapatientsthemeanfollow-uptimewas4.3±3.2months;therateofcompleteablationwas 66.6%((4/6);residualrate=33.3%).Thecompleteablationratewasstatisticallydifferentbetweenthetwogroups(P<0.05). Conclusion:Irreversibleelectroporationablationforunresectablelargehepatocellularcarcinomaissafe,withnomajor complications.Short-termefficacyisrelativelygood;however,long-termefficacyremainstobeexplored.