Research of curved water-cooled microwave ablation of diaphragmatic dome of HCC under laparoscopy

doi:10.3877/cma.j.issn.1674-6899.2023.01.011

Abstract

Abstract:

Objective

To investigate the operation advantages , safety and effectiveness of curved water-cooled microwave ablation in the treatment of liver cancer on diaphragmatic dome.

Methods

To explore the advantages, safety and effectiveness of the curved water-cooled ablation for HCC on diaphragmatic dome admitted to Shanghai Mengchao Cancer Hospital and Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from Jan. 2015 to Dec. 2021.

Results

The curved water-cooled ablation needle has significant advantages in the treatment of HCC on the dome of the diaphragm under laparoscopy. It avoids the complications such as pneumothorax, pleural infection, diaphragmatic injury and bronchial bile duct leakage caused by the thoracic approach. And it is safe and effective.

Conclusions

The curved water-cooled microwave ablation has obvious advantages in the treatment of HCC on the dome of the diaphragm, and it is safe and effective, which is worthy of promotion in the operation of HCC on the dome of the diaphragm.

Key words: Curved ablation, Laparoscope, Diaphragmatic dome, HCC, Liver dynamic watershed theory

Hu Liu, Bolun Zhang, Hao Yang, Yi Le, Guanghao Diao, Zhaoyang Cui, Xiangning Zhao, Liang An, Haizhu Li, Jianqiang Cai, Shaogeng Zhang. Research of curved water-cooled microwave ablation of diaphragmatic dome of HCC under laparoscopy[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2023, 16(01): 44-48.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2023.01.011

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Figures/Tables 6

References 21

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项目	男(46例)	女(34例)
年龄(岁，±s)	55.0±1.0	56.2±0.9
单发肿瘤最大直径(例)
<3 cm	39	28
3～5 cm	7	6
肝病史(例)
乙型肝炎	33	20
丙型肝炎	4	6
无	9	8

项目	男(46例)	女(34例)
年龄(岁，±s)	55.0±1.0	56.2±0.9
单发肿瘤最大直径(例)
<3 cm	39	28
3～5 cm	7	6
肝病史(例)
乙型肝炎	33	20
丙型肝炎	4	6
无	9	8

治疗时间(min)	55 W	60 W	70 W
5	2.6～3.0/(3.5＋0.3)	2.8～3.2/(3.8＋0.5)	3.2～3.4/(4.0＋0.5)
8	3.0～3.5/(3.5＋0.5)	3.2～3.6/(3.8＋0.7)	3.4～3.8/(4.5＋0.7)
10	3.6～3.8/(4.2＋0.7)	3.8～4.0/(4.5＋0.7)	4.0～4.2/(5.0＋0.7)
12	3.8～4.0/(4.4＋0.7)	3.8～4.2/(4.8＋0.7)	4.0～4.5/(5.0＋0.7)
15	3.8～4.2/(4.8＋0.7)	4.0～4.5/(5.0＋0.7)	4.5～5.0/(5.5＋0.7)

治疗时间(min)	55 W	60 W	70 W
5	2.6～3.0/(3.5＋0.3)	2.8～3.2/(3.8＋0.5)	3.2～3.4/(4.0＋0.5)
8	3.0～3.5/(3.5＋0.5)	3.2～3.6/(3.8＋0.7)	3.4～3.8/(4.5＋0.7)
10	3.6～3.8/(4.2＋0.7)	3.8～4.0/(4.5＋0.7)	4.0～4.2/(5.0＋0.7)
12	3.8～4.0/(4.4＋0.7)	3.8～4.2/(4.8＋0.7)	4.0～4.5/(5.0＋0.7)
15	3.8～4.2/(4.8＋0.7)	4.0～4.5/(5.0＋0.7)	4.5～5.0/(5.5＋0.7)

项目	直径<3 cm	直径3～5 cm	AFP水平	合计[例(%)]
术后MR显示完全消融(例)	62	13	恢复正常50例、下降25例	75(93.75)
术后MR显示不完全消融(例)	2	3	下降3例、升高2例	5(6.25)
膈肌刺激(例)	2	1	－	3(3.75)
气胸/胸腔感染(例)	0	0	－	0(0.00)

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