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Objective:To retrospectively analyze the impact of adjuvant iodine-125( 125I)brachytherapy on postoperative recurrence and survival for patients with hepatocellular carcinoma (HCC) treated with partial hepatectomy with narrow resection margins. Methods:The data of 72 HCC patients who underwent partial hepatectomy with narrow resection margins from January 2011 to June 2015 at Weihai Municipal Hospital were analyzed retrospectively. The patients were divided into the adjuvant 125I brachytherapy group ( 125I group) ( n=36) and the control group ( n=36). The data of the two groups of patients were compared to study the factors influencing long-term survival outcomes and recurrence. Results:The follow-up time was (45.0±18.4) months. There were no deaths relating to 125I brachytherapy. The median recurrent free survival (RFS) was significantly longer in the 125I group than the control group (41.0 months vs 21.5 months, P<0.05). The 1-, 3- and 5-year RFS rates of the 125I group and the control group were 94.4%, 58.3%, 41.6% versus 86.1%, 33.3%, 25.0%, respectively ( P<0.05). The 1-, 3- and 5-year overall survival (OS) rates of the 125I group versus the control group were 97.2%, 69.4%, 52.8% versus 94.4%, 52.8%, 27.8%, respectively ( P<0.05). On multivariate analysis, 125I implantation was an independent factor affecting RFS and OS ( HR=2.112, 95% CI: 1.155-3.860, P<0.05; HR=2.492, 95% CI: 1.272-4.693, P<0.05). Conclusion:Adjuvant 125I brachytherapy was safe and effective for HCC patients with narrow resection margins after hepatectomy. It obviously reduced the tumor recurrence rate and prolonged the long-term RFS and OS.
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Objective To evaluate the effectiveness and safety of percutaneous transhepatic balloon dilation for the removal of common bile duct stones.Methods 60 patients of common bile duct stone were divided into two groups:PTBD group (30 cases) and endoscopic sphicterotomy (EST) group (30 cases).Postoperatively biliary tract was drained for three days.Results All stones were removed in 28 patients (93％) in PTBD group and 29 cases (97％) in EST group.Early complications occurred in 13％ in PTBD patients and in 17％ in EST patients(x2 =0.35,x2 =0.13,P ＞0.05).There was no mortality in neither group.Long-term complications such as gallstone recurrence and cholangitis in PTBD group was significantly less than that in EST group (x2 =6.41,P ＜ 0.05).Conclusions The success rate of PTBD was similar to that of EST and while in PTBD the function of Oddi's sphincter was well reserved.PTBD procedure is a valuable alternative to EST in patients with bile duct stones,especially in patients who are not suitable for EST.
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ObjectiveTo evaluate radio-frequency hemostasis in hepatectomy.MethodsFrom January 2009 to February 2011,the clinical data of 60 patients undergoing curative liver resection were divided into two groups using radio-frequency hemostasis (RFH) and clamp crushing method (CCM) respectively,RFH group (30 cases) and CCM group (30 cases).There was no difference between the 2 groups regarding the age,sex.hepatic function and tumor size.Data regarding the intra-operative and postoperative courses of the patients were analyzed.ResultsNo damage of hepatic vein occured in RFH group.Hepatic veins rupture occurred in 5 cases and massive bleeding occurred in 3 cases in CCM group.lntra-operative blood loss was significantly less in FRH group [ (219 ±62) ml] than in CCM group [ (416 ±96) ml ] (P ＜ 0.05 ).The postoperative drainage volume in RFH group was significantly less than that in CCM group on the third postoperative day.The serum ALT and T-BIL in RFH group was significantly lower than that in CCM group on postoperative day 1 and day 7 ( separately t =5.987,16.803,22.264,8.386,8.255,all P ＜0.05 ).Postoperative hepatic function in RFH group was significantly better than that in CCM group.ConclusionsThe use of radio-frequency hemostasis in hepatectomy is less traumatic,of less bleeding,faster recovery than clamp crashing method.