Radiofrequency ablation and laparoscopic splenectomy for the treatment of small hepatocellular carcinoma with hypersplenism

曾新桃; 罗　华; 张　伟

doi:10.3969/j.issn.1007-3969.2016.02.010

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Radiofrequency ablation and laparoscopic splenectomy for the treatment of small hepatocellular carcinoma with hypersplenism

更新时间：2025-12-31

- Radiofrequency ablation and laparoscopic splenectomy for the treatment of small hepatocellular carcinoma with hypersplenism
- China Oncology Vol. 26, Issue 2, Pages: 177-181(2016)
- 作者机构：
  
  绵阳市中心医院肝胆外科,四川,绵阳,621000
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2016.02.010
  CLC：
- Published Online：01 June 2016，
  
  Published：01 June 2016
- 稿件说明：
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曾新桃,罗　华,张　伟,等. 小肝癌合并脾功能亢进的微创治疗的方法探讨[J]. 中国癌症杂志, 2016, 26(2): 177-181.

曾新桃, 罗　华, 张　伟. Radiofrequency ablation and laparoscopic splenectomy for the treatment of small hepatocellular carcinoma with hypersplenism[J]. China Oncology, 2016, 26(2): 177-181.
曾新桃,罗　华,张　伟,等. 小肝癌合并脾功能亢进的微创治疗的方法探讨[J]. 中国癌症杂志, 2016, 26(2): 177-181. DOI： 10.3969/j.issn.1007-3969.2016.02.010.

曾新桃, 罗　华, 张　伟. Radiofrequency ablation and laparoscopic splenectomy for the treatment of small hepatocellular carcinoma with hypersplenism[J]. China Oncology, 2016, 26(2): 177-181. DOI： 10.3969/j.issn.1007-3969.2016.02.010.

摘要

背景与目的：肝癌切除、脾切除是目前治疗肝癌合并脾功能亢进的主要手段，但传统开腹手术创伤大。本研究探讨肝癌射频消融(radiofrequency ablation，RFA)联合腹腔镜脾切除(laparoscopic splenectomy，LS)治疗小肝癌合并脾功能亢进的安全性及可行性。方法：27例肝癌(直径＜3 cm)合并脾功能亢进患者，在全麻下行RFA及LS，分析其临床资料。结果：中转开腹脾切除1例，中转为手助腹腔镜脾切除2例，RFA治疗肝脏肿瘤31个。术中出血量110~900 mL，中位出血量320 mL，手术时间72~127 min，中位手术时间107 min；腹壁皮下广泛气肿1例，术后2 d吸收；术后胰漏1例，经保守治疗治愈；术后腹腔大出血1例，再次开腹手术止血，恢复良好；腹水9例，经补充白蛋白和利尿等治疗，腹水消退；无死亡病例。结论：经选择的病例，RFA联合LS治疗小肝癌合并脾功能亢进微创、安全、可行。

Abstract

Background and purpose: Liver cancer resection and splenectomy are the main methods to treat hepatocellular carcinoma and hypersplenism. The aim of this study was to discuss the safety and feasibility of simultaneous radiofrequency ablation (RFA) and laparoscopic splenectomy (LS) for the treatment of small hepatocellular carcinoma with hypersplenism. Methods: Twenty-seven patients with small hepatocellular carcinoma and cirrhotic hypersplenism underwent RFA and LS. The clinical data were also analyzed. Results: The surgery was converted to an open surgery in 1 patient

while laparoscopic splenectomy in a hand-assisted manner was performed in 2 patients. There were 31 liver tumors treated with RFA. Blood loss were 110-900 mL (mean=320 mL). Operation time were 72-127 min (mean=107 min). Subcutaneous emphysema occurred in 1 patient

and pancreatic leakage in another patient. Nine patients developed ascites. one patient suffered from massive haemorrhage

and emergency operation was adopted to stop bleeding. This patient recovered well after operation. No death was found during the hospitalization. Conclusion: Combining RFA with LS for the treatment of liver cancer and hypersplenism is minimally invasive

safe

and feasible.

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