论文部分内容阅读
目的探讨腹腔镜切除并联合应用射频消融和~(125)I 粒子植入治疗肝转移癌的临床价值。方法对62例术前经 CT 或 MR 确诊肝脏有转移灶的患者,行腹腔镜下肝转移瘤切除或射频消融,最后将~(125)粒子植入肝脏肿瘤部位。结果术中超声发现新病灶17个,所有患者均顺利行腹腔镜切除或射频消融及~(125)粒子植入。2例术后出现肝脓肿,1例术后发生腹腔少量出血,余无严重并发症。125个转移病灶位于肝脏右后内叶或巨大仅行腹腔镜下射频消融及~(125)粒子植入,22例患者的38个边缘转移病灶行离体切除。随访12～25个月(平均22.3个月),有12例转移癌未见液化,行腹腔镜下二次射频及~(125)粒子植入。1年生存率为74.2%(46/62),2年生存率为59.7%(37/62)。结论腹腔镜切除并联合应用射频消融和~(125)粒子植入治疗肝转移癌具有微创、安全、有效,术后恢复快等优点。
Objective To investigate the clinical value of laparoscopic resection combined with radiofrequency ablation and ~ (125) I particle implantation in the treatment of liver metastases. Methods Sixty-two patients with liver metastases diagnosed preoperatively by CT or MR underwent laparoscopic resection of liver metastases or radiofrequency ablation. Finally, ~ (125) particles were implanted into liver tumor sites. Results Intraoperative ultrasound found 17 new lesions, all patients underwent laparoscopic resection or radiofrequency ablation and ~ (125) implantation. 2 cases of postoperative liver abscess, 1 case of postoperative abdominal a small amount of bleeding, I no serious complications. 125 metastatic lesions were located in the right posterior internal lobe of the liver or only undergoing laparoscopic radiofrequency ablation and ~ (125) implantation of the liver. Thirty-eight marginal metastatic lesions were excised from the 22 patients. All cases were followed up for 12 to 25 months (average 22.3 months). No metastasis was found in 12 cases. Laparoscopic second radiofrequency and ~ (125) implantation were performed. The 1-year survival rate was 74.2% (46/62), and the 2-year survival rate was 59.7% (37/62). Conclusions Laparoscopic resection combined with radiofrequency ablation and ~ (125) particle implantation for the treatment of liver metastases has the advantages of minimally invasive, safe, effective and rapid postoperative recovery.