Clinical effect on microwave coagulo-necrotic therapy combined with laparoscopic splenectomy in treatment of primary hepatocellular carcinoma complicated by hypersplenism
10.3969/j.issn.1001-5256.2018.01.029
- VernacularTitle:微波凝固坏死疗法联合腹腔镜脾切除术治疗原发性肝癌合并脾功能亢进的效果观察
- Author:
Shumin LIU
1
;
Qiu SUN
;
Meiju ZHANG
Author Information
1. 宝鸡市人民医院 介入科
- Keywords:
liver neoplasms;
hypersplenism;
catheter ablation;
splenectomy;
treatment outcome
- From:
Journal of Clinical Hepatology
2018;34(1):142-146
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and safety of microwave coagulo-necrotic therapy (MCN) combined with laparoscopic splenectomy (LS) in the treatment of primary hepatocellular carcinoma (PHC) complicated by hypersplenism. Methods A retrospective analysis was performed for the clinical data of 22 PHC patients with hypersplenism who were admitted to Baoji Municipal People' s Hospital from January 2008 to December 2012 and underwent MCN combined with LS. Their clinical data were collected, and postoperative complications and survival were observed. The t-test was used for comparison of continuous data, and the Kaplan-Meier method was used to plot cumulative survival curves. Results In MCN therapy, 5 patients underwent thoracotomy, 15 underwent laparotomy, and 2 underwent laparoscopic surgery; in LS treatment, 17 underwent hand-assisted LS and 5 underwent simple LS. The mean time of operation was (303. 24 ±56. 02) min, the mean blood loss volume was (146. 92 ± 60. 72) ml, and the mean weight of the resected spleen was (670. 42 ± 204. 54) g. Of all patients, 6 (27. 27％ ) experienced postoperative recurrence, 5 (22. 73％ ) experienced portal vein thrombosis, and 2 (9. 09％ ) experienced pleural effusion. There was a significant increase in platelet count at 1 month after surgery [ (15. 72 ± 5. 47) ×104/μl vs (4. 43 ±1. 03) ×104/μl, t = 6. 83, P ＜ 0. 001]. The 1-, 3-, and 5-year overall survival rates after surgery were 90. 91％, 68. 18％, and 59. 09％, respectively, and the 1-, 3-, and 5-year disease-free survival rates were 59. 09％, 13. 64％, and 13. 64％, respectively.Conclusion MCN combined with LS is safe, effective, and feasible in the treatment of PHC complicated by hypersplenism.
