摘要
目的 探讨腹腔镜下冷循环射频消融联合贲门周围血管离断治疗小肝癌合并严重门脉高压症的安全性及可行性。方法 2012年1月至2015年6月本院采用腹腔镜下冷循环射频消融联合贲门周围血管离断及脾切除治疗小肝癌合并有门静脉高压症消化道出血12例患者,同期行腹腔镜下贲门周围血管离断术及脾切除治疗门静脉高压症消化道出血28例乙肝肝硬化患者,比较两组的临床资料。结果 所有手术均在腹腔镜下顺利完成,无中转开腹。两组患者手术时间、术中出血量、手术并发症及术后住院时间比较,差异无统计学意义（均P〉0.05）。随访3~36个月,两组有3例消化道再出血,保守治疗痊愈;1例肝肿瘤消融不完全,CT引导下再次消融治疗,无肝癌复发。结论 腹腔镜下冷循环射频消融对肝功能损伤小,具有微创的优点,联合贲门周围血管离断术是治疗小肝癌合并门脉高压症消化道出血的一种安全、有效的术式,值得临床推广。
Objective To evaluate the safety and feasibility of laparoscopic cool-tip radiofrequency ablation plus periesophagogastric devascularization and splenectomy for the patients with small hepatocellular carcinoma and severe portal vein hypertension complicated with digestive tract hemorrhage. Methods From January 2012 to June 2015,1aparoscopic cool-tip radiofrequency ablation plus periesophagogastric devascularization and splenectomy were performed in our department on 12 patients with small hepatocellular carcinoma and severe portal vein hypertension complicated with digestive tract hemorrhage （HCC ＋PVH group）, and laparoscopic periesophagogastric devascularization and splenectomy on 28 patients with severe portal vein hypertension complicated with digestive tract hemorrhage （PVH group）. Clinical data were compared between the two groups. Results All operations were successfully completed without converting to laparotomy. There were no significant differences in operation time, intraoperative blood loss, post- operative complication rate and hospital stay between the two groups （all P〉O.05）. After follow-up of 3-36 months, no cancer recurrence was found except that one case with incomplete ablation received CT-guided RAF again. Rebleeding occurred in 3 cases in the two groups and was recured through conservative treatment. Conclusions Laparoscopic cool-tip radiofrequency ablation plus periesophagogastric devascularization and splenectomy is a safe, feasible and effective treatment for the patients with small hepatocellular carcinoma and severe portal vein hypertension complicated with digestive tract hemorrhage.
出处
《消化肿瘤杂志（电子版）》
2015年第4期200-203,共4页
Journal of Digestive Oncology(Electronic Version)
关键词
肝癌
冷循环射频消融
腹腔镜
贲门周围血管离断术
门脉高压症
Laparoscopic cool-tip radiofrequency ablation
periesophagogastric devascularization and splenectomy
hepatocellular carcinoma
portal vein hypertension
