合并严重肝硬化的肝癌患者腹腔镜下消融治疗

摘要

Objective To explore the clinical treatment strategies of laparoscopic hepatocellular carcinoma ablation for patients with severe cirrhosis background.Methods We analyzed the clinical data of 430 patients and analyzed the indications,key techniques,efficacy and safety of laparoscopic hepatocellular carcinoma ablation for patients with severe cirrhosis background,and summarized the related experiences.Results The first complete ablation rate for the entire cohort was 94％,the 2-year local recurrence rate was 2.8％.No significant complications were found postoperatively.Conclusions Laparoscopic hepatocellular carcinoma ablation is a minimally invasive,safe and effective treatment strategy for patients with small cancer under severe cirrhosis background.Especially when the tumor is located in the " high-risk parts" for ablation,it could be a preferred method for pre-transplant treatment of these patients.%目的 探讨合并严重肝硬化肝癌患者的腹腔镜下消融治疗策略,旨在为其规范治疗提供参考.方法 对解放军302医院2013-2016年开展的430例腹腔镜肝癌消融术患者临床资料进行总结,对严重肝硬化背景下的腹腔镜肝癌消融治疗的适应证、技术要点、疗效及安全性进行分析.结果 全组患者初次完全消融率94％,2年局部复发率2.8％,无明显并发症.结论 对于严重肝硬化背景的小肝癌患者,尤其当肿瘤处于经皮消融治疗的“高危部位”,腹腔镜下消融治疗是一种微创、安全、有效的治疗策略,可以作为首选的移植前过渡治疗.