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Objective To evaluate the feasibility,safety,and efficacy of laparoscopic radiofrequency ablation(RFA) for the treatment of hepatic cavernous hemangioma(HCH) in patients with liver cirrhosis.Methods A total of 15 patients with HCH and liver cirrhosis received laparoscopic RFA under general anesthesia between March 2001 and August 2005.There were 6 men and 9 women,with a mean age of 46.2?7.0 years.All the patients had complained of obvious symptoms of abdominal discomfort,pain,or fullness. The etiologic factor of liver cirrhosis was hepatitis B in 13 patients and hepatitis C in 2 patients.The Child classification revealed grade A in 10 patients and grade B in 5 patients.A total of 20 liver lesions located on the surface of the liver or adjacent to the gallbladder,with a mean diameter of 7.2?1.4 cm,were identified preoperatively in the 15 patients by ultrasonography,helical CT scans,or MRI.The platelet count was(31.2?10.4)?10~9/L.Co-morbidities included chronic calculous cholecystitis in 3 patients and diabetes mellitus in 2 patients.Laparoscopic ultrasonography and liver biopsy were routinely performed during the operation.Results Laparoscopic RFA was successfully performed in all the 15 patients and laparoscopic cholecystectomy was conducted simultaneously in 3 patients.The ablation time per lesion was 68.8?34.0 min,and the total operative time was 120.0?28.0 min.No severe complications,such as intraperitoneal hemorrhage,gastrointestinal injury,diaphragmatic injury,bile leakage,and liver function failure,developed during and after the operation.Complete tumor necrosis was achieved in all the 20 lesions(100%,20/20) on contrast-enhanced helical CT scans 1 month after the treatment.During a follow-up period of 5~31 months,symptoms completely disappeared in 13 patients and significantly subsided in 2 patients.Conclusions Laparoscopic radiofrequency ablation is a feasible,safe,and effective treatment for hepatic cavernous hemangioma complicating liver cirrhosis.
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Objective To investigate the feasibility and efficacy of surgical resection combined with radiofrequency ablation (RFA) for multifocal hepatocellular carcinomas (HCC) in patients with cirrhosis. Methods A total of 18 patients with multifocal HCCs and liver cirrhosis was treated between August 2003 and January 2006. Forty-six hepatic lesions were identified preoperatively by ultrasonography, helical CT, or MRI. Ten patients were found as having 2 lesions, 6 patients having 3 lesions, and 2 patients, 4 lesions. Under general anesthesia, segmental hepatectomy for major lesions (with a 2cm resection margin) and RFA therapy for minor lesions were performed. Results The combination therapy was performed successfully in all the 18 patients. A cholecystectomy was performed simultaneously for gallstones in 2 patients, and a splenectomy with para-esophagogastric devascularization was performed for portal hypertension in 1 patient. The surgical resection time was 37.4?8.8 min, the RFA time per lesion was 25.6 ? 8.9 min, the total RFA time was 39.8 ?14.7 min, the total operative time was 152.4?30.8 min, and the intraoperative blood loss was 465.6 ? 171.0 ml. No severe complications, such as intraabdominal hemorrhage, gastrointestinal tract injury, diaphragmatic injury, and liver function failure, developed after operations. No residual tumor was found on the margin of surgical resection and a complete lesion necrosis was achieved in the RFA regions on contrast-enhanced helical CT scanning 1 month after the procedure. During a follow-up period for 6~31 months (mean, 15.5 months), 5 patients were diagnosed as having new malignant nodules and were given a percutaneous RFA therapy. Out of the 5 patients, one died from tumor recurrence and lung metastases, and two patients died from liver failure at 7 and 16 months after treatment, respectively. Conclusions Surgical resection combined with RFA therapy is a feasible, safe, and effective treatment for proper patients with multifocal HCCs and liver cirrhosis, preserving impaired liver functions to the greatest advantages.
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Objective: To assess potential mechanisms responsible for the antitumor activities of the streptococcal preparation OK 432.Methods: C57BL/6 mice were transplanted subcutaneously with 5?10 5 B16 melanoma cells and treated with OK 432 (1KE/week?3) or saline (control) intraperitoneally 3 days after the inoculation and tumor size was measured biweekly. The effects of OK 432 on splenocyte cytokines (IL 2, IL 4, IL 6, IL 10, IL 12, IFN ?) production of tumor bearing mice were investigated both in vitro and in vivo. Results: OK 432 significantly inhibited B16 melanoma growth and lengthened the survival time of the mice as compared with control ( P
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Objective To study the inhibitory effect of intrasplenic injection of retroviral packaging cells encoding human interleukin-2 (hIL-2) and mouse interleukin-12 (mIL-12) fusion gene on the growth of chemically induced hepatocellular carcinoma in rats. Methods The retroviral vector GCIL12EIL2PN encoding hIL-2 and mIL-12 fusion gene was constructed. The retroviral packaging cell line PA317 transfected with the vector was injected into the spleens of rats with established chemically induced hepatoma on on the 90th day (early-stage treatment) or the 105th day (late-stage treatment). The survival time and toxic effect were observed. The serum mIL-12 and hIL-2 levels were assayed with ELISA, and the cytotoxicity of the natural killer (NK) cells was measured by means of a 51Cr-release assay using YAC-1 tumor cells as the target. Results The average survival time (after chemical induction) in the early-stage treatment rats and the late-stage treatment rats were 188.1?14.2 days and 168.5?13.6 days, respectively, in IL-12+IL-2 combination gene treatment group, and it was longer than that of IL-12 gene treatment group (168.2?13.4 days and 149.1?13.8 days, respectively, P