Objective To analyze the application of bipolar radiofrequency-assisted device or monopolar radiofre-quency-assisted ablation in treatment for liver cancer by operation.
Methods From June 2008 to May 2012， 56 patients with liver cancer underwent operation with bipolar radiofrequency-assisted device （Habib group， n=22） or monopolar radiofrequency-assisted ablation （mRFA group， n=34） were selected retrospectively. The operation time， postoperative morbidity， hospital stay， hospital costs， intraoperative bleeding， and therapeutic effects were compared in two groups.
Results The percentage of patients with liver cirrhosis was 85.7% （48/56）， with multiple tumors was 12.5% （7/56）， underwent laparoscopic operation was 16.1% （9/56）. Patients with the tumor diameter greater than 5 cm in the Habib group were more than that in the mRFA group （P=0.000）， the laparoscopic surgery proportion had no significant difference in two groups （P=0.074）. ① The intraoperative bleeding in the Habib group was more than that in the mRFA group （P=0.000）. Two patients were adopted a hepatic portal blocking and 3 patients with intraoperative blood transfusion in the Habib group. ② The operation time in the Habib group was longer than that in the mRFA group （P=0.021）， but there was no difference of the operation time in two groups patients with tumor diameter greater than 5 cm （P=0.191）. ③ The postoperative morbidity had no obvious difference in two groups 〔18.2% （4/22） versus 11.8% （4/34）， P=0.780〕. ④ The
hospital stay and the hospital costs in the Habib group were significantly more than those in the mRFA group （P=0.001， P=0.004）.⑤The tumor residuals were found in two patients with tumor diameter greater than 5 cm.
Conclusions Treatment for liver cancer by operation with bipolar radiofrequency-assisted device or monopolar radiofrequency-assisted ablation is safe and effective. The monopolar radiofrequency-assisted ablation has advantages of less intraoperative bleeding， more minimal invasion proportion， less hospital stay and hospital costs for liver cancer patients with small tumor （diameter＜3 cm）， multifocal tumors and minimal invasion conditions as compared with bipolar radiofrequency-assisted device. Operation with bipolar radiofrequency-assisted device in patients with larger tumors （diameter≥5 cm） resection might be a better choice.
Citation：
ZHENG Yamin,WANG Yuehua,ZHAO Jing,LIU Dongbin,LIU Jiafeng,LI Fei,.. Treatment for Liver Cancer by Operation with Bipolar Radiofrequency-Assisted Device or Monopolar Radiofrequency-Assisted Ablation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(8): 900-904. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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， 52(66)：1685-1687.
|
- 1. Nagorney DM， van Heerden JA， Ilstrup DM， et al. Primary hepatic malignancy：surgical management and determinants of survival[J]. Surgery， 1989， 106(4)：740-748.
- 2. 000 cases[J]. Cancer， 2005， 103(6)：1201-1209.
- 3. 任正刚. 原发性肝癌的射频毁损治疗进展[J]. 中国普外基础与临床杂志， 2007， 14(1)：5-7.
- 4. Jiao LR， Navarra G， Weber JC， et al. Radiofrequency assisted liver resection-a novel technique[J]. Hepatogastroenterology，.
- 5. Brui XJ， Sherman M. Management of hepatocellular carci-noma[J]. Hepatology， 2005， 42(5)：1208-1236.
- 6. Chen MS， Li JQ， Zheng Y， et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma[J]. Ann Surg， 2006， 243(3)：321-328.
- 7. Lau WY， Lai EC. The current role of radiofrequency ablation in the management of hepatocellular carcinoma：a systematic review[J]. Ann Surg， 2009， 249(1)：20-25.
- 8. 徐克成， 杨大明. 射频治疗原发性肝癌[J]. 胃肠病学和肝病学杂志， 2009， 18(4)：305-307.
- 9. 刘磊， 赵永福. 肝癌的射频消融治疗[J]. 医药论坛杂志， 2009， 30(13)：125-127.
- 10. Wong SL， Edwards MJ， Chao C， et al. Radiofrequency ablation of unresectable hepatic tumors[J]. Am J Surg， 2001， 182(6)：552-557.
- 11. Pai M， Frampton AE， Mikhail S， et al. Radiofrequency assisted liver resection：analysis of 604 consecutive cases[J]. Eur J Surg Oncol， 2012， 38(3)：274-280.
- 12. Pai M， Kyriakides C， Mikhail S， et al. Radiofrequency-assisted hepatic resection[J]. Ann Surg Oncol， 2011， 18(12)：3391-3396.
- 13. Weber JC， Navarra G， Jiao LR， et al. New technique for liver resection using heat coagulative necrosis[J]. Ann Surg， 2002， 236(5)：560-563.
- 14. Mitsuo M， Takahiro T， Yasuko T， et al. Radiofrequency (RF)-assisted hepatectomy may induce severe postoperative liver damage[J]. World J Surg， 2007， 31(11)：2208-2212.
- 15. Akyildiz HY， Morris-Stiff G， Aucejo F， et al. Techniques of radiofrequency-assisted precoagulation in laparoscopic liver resection[J]. Surg Endosc， 2011， 25(4)：1143-1147.
- 16. Jiao LR， Ayav A， Navarra G， et al. Laparoscopic liver resection assisted by the laparoscopic Habib Sealer[J]. Surgery， 2008， 144(5)：770-774.
- 17. Li M， Zhang W， Li Y， et al. Radiofrequency-assisted versus clamp-crushing parenchyma transection in cirrhotic patients with hepatocellular carcinoma：a randomized clinical trial[J]. Dig Dis Sci， 2012 Sep 25.[Epub ahead of print].
- 18. Galizia G， Castellano P， Pinto M， et al. Radiofrequency-assisted liver resection with a comb-shaped bipolar device versus clamp crushing：a clinical study[J]. Surg Innov， 2012， 19(4)：407-414.
- 19. Tateishi R， Shiina S， Teratani T， et al. Percutaneous radiofrequency ablation for hepatocellular carcinoma. An analysis of.
- 20. 王振， 钱叶本. 小肝癌射频消融术与手术切除术疗效的Meta分析[J]. 肝胆外科杂志， 2011， 19(1)：23-27.
- 21. 陈敏山， 李锦清， 张耀军. 射频消融在小肝癌治疗中的地位[J]. 癌症， 2007， 26(5)：449-452.
- 22. 陈敏山， 高恒军， 李锦清. 肝癌射频消融治疗合理选择与临床评价[J]. 中国实用外科杂志， 2008， 28(8)：613-615.
- 23. 黄建钊， 刘江伟， 孙倩， 等. 射频消融与手术切除治疗肝癌的疗效比较[J]. 广东医学， 2012， 33(13)：1991-1993.
- 24. 师礼鹏， 王一. 国内外肝癌射频消融术与手术切除3年生存率Meta分析[J]. 齐鲁医学杂志， 2009， 24(5)：413-415.
- 25. 韩风， 张玲， 邱大鹏， 等. 射频消融术在不能手术切除肝癌治疗中的应用[J]. 临床医学， 2007， 27(7)：5-6.
- 26. 蒙广星. 射频消融治疗肝癌的临床现状及延伸[J]. 医学综述， 2011， 17(1)：70-72.
- 27. ， 52(66)：1685-1687.
