Curative effect of laparoscopic microwave coagulation combined with hepatectomy for liver cirrhosis complicated with hepatocellular carcinoma
10.3877/cma.j.issn.2095-3232.2015.05.009
- VernacularTitle:腹腔镜下微波固化联合肝切除治疗肝硬化合并肝细胞癌的疗效
- Author:
Kelin ZHANG
1
;
Changzhen SHANG
;
Wenda LI
;
Lei ZHANG
;
Hongwei ZHANG
;
Leibo XU
;
Chunhong CAO
;
Yajin CHEN
Author Information
1. 中山大学孙逸仙纪念医院肝胆外科
- Keywords:
Liver cirrhosis;
Liver neoplasms;
Microwaves;
Laparoscopes
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2015;(5):293-296
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the safety and curative effect of laparoscopic microwave coagulation combined with hepatectomy for liver cirrhosis complicated with hepatocellular carcinoma (HCC).MethodsClinical data of 58 patients with liver cirrhosis complicated with HCC diagnosed and treated in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between Janunary 2009 and November 2013 were retrospectively studied. The patients were divided into the microwave coagulation combined with hepatectomy group (the combination group) and the simple microwave coagulation group (the coagulation group) according to different treatment methods. Among the 37 patients in the combination group, 29 were males and 8 were females with average age of (54±9) years old. Among the 21 patients in the combination group, 17 were males and 4 were females with average age of (58±10) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients in the coagulation group only underwent laparoscopic microwave coagulation, while the patients in the combination group underwent hepatectomy after marking a incision line 1-2 cm from the tumor edge and undergoing microwave coagulation. The intraoperative blood loss and the duration of operation of two groups were observed. The comparison of the intraoperative blood loss and the duration of operation were conducted using Wilcoxon rank-sum test and the survival analysis was conducted using Log-rank test and Z test.ResultsThe intraoperative blood loss of the combination group was 146 (58-250) ml, which was signiifcantly higher than 13 (10-25) ml of the coagulation group (Z=7.824,P<0.05). The duration of operation of the combination group was 177 (83-275) min, which was signiifcantly longer than 93 (36-135) min of the coagulation group (Z=8.650,P<0.05). The 3-year cumulative survival rate and 1-, 3-year disease free survival of the combination group were respectively 97%, 83%, 92%, which were signiifcantly higher than 64%, 71%, 43% of the coagulation group (Z=10.054, 9.011, 7.112;P<0.05).ConclusionsLaparoscopic microwave coagulation combined with hepatectomy for liver cirrhosis complicated with HCC is safe and effective. The long-term curative effect is better than that of simple laparoscopic microwave coagulation.
