冷冻手术治疗肝细胞癌

胃肠病学和肝病学杂志 Pub Date : 2008-01-01 DOI:10.1142/9789814329668_0029

N. Lizhi

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引用次数: 0

摘要

冷冻手术是治疗不可切除的肝细胞癌的一种重要方式。肝细胞癌的冷冻手术形式有术中有切除或不切除的冷冻手术、腹腔镜下的肝脏冷冻手术和超声或CT引导下的经皮肝脏冷冻手术。作为一种局部治疗，冷冻消融比其他形式的治疗具有一定的优势:它能够只破坏肝脏中的肿瘤组织，而保留更多的非受损伤组织;由于大血管中血流的升温作用，靠近这些血管系统的肿瘤可以安全地进行冷冻消融;肝脏冷冻消融术治疗肝脏多发肿瘤比手术切除更有效。冷冻手术联合经动脉化疗栓塞(TACE)、酒精注射或125碘粒子植入术疗效互补。肝细胞癌的临床冷冻治疗原则为:肝内肿瘤5 cm，数量≤3个，可术中或经皮冷冻;肝内肿瘤5 cm，应行TACE，然后经皮冷冻手术;肝内肿瘤5cm，边缘不规则，可行术中或经皮冷冻手术，然后在肿瘤边缘注射酒精或植入125碘粒子。

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Cryosurgery for hepatocellular carcinoma

Cryosurgery is an important modality for treatment of unresectable hepatocellular carcinoma (HCC). There are different forms of cryosurgery for HCC which are intraoperative cryoablation with or without excision, laparoscopic liver cryosurgery, and percutaneous liver cryoablation under guiding of ultrasonography or CT. As a local therapy, cryoablation carries certain advantages over other forms of treatment:it is able to destroy only the tumor tissue in liver while sparing more noninvolved tissues; because of the warming effect of flowing blood in the large blood vessels, tumors close to these vessel system can safely undergo cryoablation; liver cryoablation is more effective than surgical resection in treating multiple tumors in the liver. Cryosurgery with combination of transarterial chemoembolization (TACE), alcohol injection or 125iodine seed implantation has a complementary efficacy. Clinically, cryosurgery for HCC is performed according to the following principles:tumors in liver 5 cm,≤3 in number, may be performed intraoperative or percutaneous cryosurgery; tumor in liver 5 cm,should receive TACE, and then percutaneous cryosurgery; tumor in liver 5 cm with irregular margin, may be given intraoperative or percutaneous cryosurgery, and then alcohol injection or 125iodine seed implantation in the margin of tumor.

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来源期刊

胃肠病学和肝病学杂志

自引率

0.00%

发文量

7976

期刊介绍： Chinese Journal of Gastroenterology and Hepatology is a digestive academic journal sponsored by Zhengzhou University. It is open to submissions from home and abroad. The journal was founded in 1992 and officially approved in 1993. It has won the "Second Prize of Henan Province Excellent Science and Technology Journal". It was published quarterly from 1992 to 2002, bimonthly from 2003 to 2007, and monthly from 2008 to date. Since 2002, it has been included in the statistical source journals of scientific and technological papers of the Ministry of Science and Technology (core journals of the Ministry of Science and Technology). The purpose of publishing is to focus on improvement, while paying attention to popularization, striving to achieve popularization and improvement at the same time, following the principle of "improvement as the guide, improvement on the basis of popularization", to guide and promote the development of disciplines. In the publishing process, we pay attention to the advancement, readability, applicability, innovation, orientation, timeliness and policy of the content, and strive to achieve the standardization of editing and publishing.