Xiao Senlin,Li Zhonghu,Ma Kuansheng,Li Xiaowu.Radiofrequency-assisted versus clamp-crushing liver resection for hepatocellular carcinoma with cirrhosis: a retrospective cohort study[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(15):1767-1772.
Xiao Senlin,Li Zhonghu,Ma Kuansheng,Li Xiaowu.Radiofrequency-assisted versus clamp-crushing liver resection for hepatocellular carcinoma with cirrhosis: a retrospective cohort study[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(15):1767-1772.DOI:
目的 探讨射频辅助肝切除术治疗合并肝硬化的HCC患者的安全性及有效性。 方法 2011年1月1日至2012年12月31日本研究所分别实施射频辅助肝切除术189例,钳夹法肝切除术197例,回顾分析两组患者的临床资料及随访结果。 结果 两组术中均无死亡病例发生。射频辅助肝切除组和钳夹法肝切除组比较,手术时间缩短[(241.3±79.7) min vs (267.0±108.1) min;P=0.008]、出血量减少[(484.6±472.7) mL vs (770.1±973.6) mL;P=0.005]、输血率降低(16.9% vs 33.0%;P=0.000)及第一肝门阻断率降低(52.9% vs 65.5%;P=0.012),差异均有统计学意义,术后并发症发生率(33.3% vs 28.9%;P=0.351)、死亡率(4.8% vs 3.6%;P=0.552)、术后住院时间[(16.6±8.1) d vs (17.1±8.4) d;P=0.591]差异均无统计学意义。射频辅助肝切除组和钳夹法肝切除组的1年、3年总生存率分别为(76.6% vs 80.1%;P=0.765)、(49.5% vs 58.1%;P=0.580),1年、3年无瘤生存率分别为(50.1% vs 56.4%;P=0.501)、(37.6 % vs 42.1%;P=0.421),差异均无统计学意义。 结论 射频辅助肝切除术治疗治疗合并肝硬化的HCC是安全有效的。
Abstract
Objective To explore the safety and efficacy of radiofrequency-assisted liver resection (RF-LR) for hepatocellular carcinoma (HCC) with cirrhosis. Methods A retrospective study was performed on the patients treated with RF-LR (n=189) and clamp-crushing liver resection (CC-LR
n=197) in our hospital from January 1
2011 to December 31
2012. Clinical and follow-up data was compared between the 2 groups. Results No death occurred during the operation in the 2 groups. There were statistically significant differences between the 2 groups in operation time (241.3±79.7 vs 267.0±108 min
P=0.008)
blood loss (484.6±472.7 vs 770.1±973.6 mL
P=0.005)
blood transfusion rate (16.9% vs 33.0%
P=0.000) and proportion of first hepatic portal inflow occlusion (52.9% vs 65.5%
P=0.012). No statistically significant differences were found between the 2 groups in total complication rate (33.3% vs 28.9%
P=0.351)
mortality (4.8% vs 3.6%
P=0.552) and postoperative hospital stay (16.6±8.1 vs 17.1±8.4; P=0.591). The 1- and 3-year overall survival rates for RF-LR group and CC-LR were 76.6% vs 80.1% (P=0.765) and 49.5% vs 58.1% (P=0.580)
respectively. Accordingly
the 1- and 3-year disease-free survival rates were 50.1% vs 56.4% (P=0.501) and 37.6% vs 42.1% (P=0.421) with no statistically significant differences between the groups. Conclusion RF-LR is safe and effective for HCC patients with cirrhosis.