Usefulness of intraoperative radiofrequency thermoablation of liver tumours associated or not with hepatectomy
Usefulness of intraoperative radiofrequency thermoablation of liver tumours associated or not with hepatectomy
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DOI：
10.1053/ejso.2000.1000
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发表时间：
2000-12-01
期刊：
影响因子：
--
通讯作者：
de Baere, T
中科院分区：
文献类型：
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作者：
Elias, D;Goharin, A;de Baere, T
简介：发射射频（RF）波的探头能够通过热消融破坏肿瘤组织。本研究的目的是进行一项前瞻性估计的好处，在肝和肝外切除术的目的是获得RO状态的患者中，疾病是臭名昭著的被认为是不可切除的。方法：21例患者进行了手术，1997年1月至1999年9月。在17例病例中，RF与肝切除术相关，其中9例与肝外病变切除术相关。在2例病例中，广泛切除肝外病灶与RF联合治疗肝转移，在2例病例中最终单独进行RF。每例患者的平均肝转移数量为6.2 ± 4.3（范围1-15）。共32处病变接受了RF治疗。33个射频热消融肿瘤的平均大小为13.6+/-9.7 mm（范围5-52 mm），在所有情况下，但一个Pringle机动进行期间的RF procedure.Results：一个可能的RO切除术获得18例。无手术死亡或任何RF相关并发症发生。如果我们排除术中明显不可能破坏肝转移的病例，在平均随访17.3个月后，32个热消融病灶中仅发生1例局部复发（3%）。2年的总体和无病生存率为最初不可切除的人口分别为94.7%和22%，respectively.Conclusion：术中使用RF破坏不可切除的肝脏肿瘤增加治愈性切除率。未来射频技术的进步和射频过程中充分的血管夹闭应该会提高这一比率。(C)2000年哈考特出版社有限公司
Introduction: A probe emitting radiofrequency (RF) waves is able to destroy tumour tissue by thermal ablation. The purpose of this study was to undertake a prospective estimation of the benefit of RF thermoablation of liver tumours during hepatic and extrahepatic resections aimed at obtaining an RO status in patients in whom disease is notoriously considered unresectable.Method: Twenty-one patients underwent surgery between January 1997 and September 1999. In 17 cases, RF was associated with a hepatectomy and in nine of these cases with resection of extrahepatic lesions. In two cases, extensive resection of extrahepatic lesions was associated with RF to treat liver metastases, and in two cases RF was ultimately performed alone. The mean number of liver metastases was 6.2+/-4.3 (range 1-15) per patient. A total of 32 lesions were treated with RF. The mean size of the 33 RF-thermoablated tumours was 13.6+/-9.7 mm (range 5-52 mm), and in all but one case, a Pringle manoeuvre was performed during the RF procedure.Results: A probable RO-resection was obtained in 18 cases. No operative deaths or any RF-related complications occurred. If we exclude the case in which it was clearly impossible to destroy liver metastases intraoperatively, only one local recurrence occurred (3%) among the 32 thermoablated lesions after a mean follow-up of 17.3 months. The 2-year overall and disease-free survival rates for this initially unresectable population were 94.7% and 22%, respectively.Conclusion: Intraoperative use of RF to destroy unresectable liver tumours increases the rate of curative resections. Future progress in RF technology and adequate vascular clamping during RF should increase this rate. (C) 2000 Harcourt Publishers Ltd.