Short- and long-term outcomes of hepatectomy with or without radiofrequency-assist for the treatment of hepatocellular carcinomas: a retrospective comparative cohort study.
Short- and long-term outcomes of hepatectomy with or without radiofrequency-assist for the treatment of hepatocellular carcinomas: a retrospective comparative cohort study.
复制标题
DOI：
10.5582/bst.2014.01142
复制
发表时间：
2015-02
影响因子：
5.5
通讯作者：
R. Guo;Xiaobin Feng;S. Xiao;Jun Yan;F. Xia;K. Ma;Xiaowu Li
中科院分区：
文献类型：
--
作者：
R. Guo;Xiaobin Feng;S. Xiao;Jun Yan;F. Xia;K. Ma;Xiaowu Li
本研究的目的是比较射频辅助肝切除术（RFLR）和传统钳夹粉碎性肝切除术（CCRs）的短期和长期结局，并评价RFLR的安全性和有效性。2008年1月至2012年12月期间，共确定了597例接受根治性肝切除术的肝细胞癌（HCC）患者。共有272例患者接受了RFLR，325例患者接受了Cycloid。对短期和长期结果进行了比较。RFLR组和CCR4组患者的基线特征相似。RFLR组术中失血量较少（485.5 vs. 763.2 mL，p = 0.003）、较低的输血需求率（19.1 vs. 31.7%，p ≤ 0.01）、较短的手术时间（211 vs. 296分钟，p ≤ 0.01）和较低的血管流入阻塞率（25.7 vs. 33.8%，p = 0.032）。两组术后胆红素和肝酶均无明显变化。两组之间的术后并发症和发病率没有显著差异。1年、2年和3年总生存率无显著差异（分别为73.8%、58.5%和55.7% vs. 80.8%、65.8%和56.2%）或无病率RFLR组和Cirrhosis组之间分别为51.9%、47.2%和46.0% vs. 54.5%、44.9%和38.5%。提示RFLR是一种安全、有效的治疗肝癌的方法。RFLR与失血量减少、输血量减少、手术时间缩短和血管流入闭塞应用减少相关。RFLR组未显示肝损伤或术后发病率或死亡率增加。
The objective of this study was to compare the short- and long-term outcomes of radiofrequency-assisted liver resection (RFLR) and conventional clamp-crushing liver resection (CCLR) and to evaluate the safety and efficiency of RFLR. Between January 2008 and December 2012, a total of 597 patients with hepatocellular carcinoma (HCC) who underwent curative hepatectomy were identified. A total of 272 patients underwent RFLR, and 325 patients received CCLR. The short- and long-term outcomes were compared. The patients in the RFLR and CCLR groups showed similar baseline characteristics. The RFLR group showed less intraoperative blood loss (485.5 vs. 763.2 mL, p = 0.003), a lower transfusion requirement rate (19.1 vs. 31.7%, p ≤ 0.01), shorter surgery duration (211 vs. 296 min, p ≤ 0.01) and a lower vascular inflow occlusion rate (25.7 vs. 33.8%, p = 0.032). No significant postoperative changes in bilirubin or liver enzymes were observed in the two groups. The degree of postoperative complications and morbidity did not significantly differ between the two groups. There were no significant differences in the 1-, 2- and 3-year overall survival rates (73.8%, 58.5%, and 55.7% vs. 80.8%, 65.8%, and 56.2%, respectively) or disease-free rates (51.9%, 47.2%, and 46.0% vs. 54.5%, 44.9%, and 38.5%, respectively) between the RFLR and CCLR groups. These results suggested RFLR was a safe and efficient method for patients with HCC. RFLR was associated with decreased blood loss, fewer blood transfusions, shorter surgery times and less vascular inflow occlusion application. The RFLR group did not show increased liver injury or postoperative morbidity or mortality.