Treatment of hepatic carcinoma with combination of laparoscopic hepatectomy,radiofrequency ablation,and Iodine-125 brachytherapy / 中国微创外科杂志

ABSTRACT

Objective To explore the efficacy of laparoscopic hepatectomy in combination with radiofrequency ablation and Iodine-125 brachytherapy in the treatment of hepatic carcinoma.Methods The study included 26 cases of hepatic carcinoma(left-sided,12 cases;right-sided,11 cases,both-sided,3 cases).There were 34 tumor lesions,with a maximum diameter of 2.8～13.0 cm.All the patients underwent laparoscopic hepatectomy in combination with radiofrequency ablation and Iodine-125 brachytherapy.Results The combination operation was successfully completed in all the cases,without conversions to open surgery.During the operation,2 new tumor lesions were founded by laparoscopic ulstrasound.Among the 36 lesions,only harmonic scalpel vaporization and Iodine-125 seeds implantation was performed in 8 cases of posterior right lobe lesions,and laparoscopic hepatectomy in combination with radiofrequency ablation and Iodine-125 seeds implantation was conducted in 28 cases of margin lesions.Follow-up checkups for 12～25 months(mean,22.3 months)showed a 1-year survival rate of 92.3%(24/26).Local tumor recurrence was seen in 3 out of 36 lesions.No severe complications occurred.Conclusions Combination of laparoscopic hepatectomy,radiofrequency ablation,and Iodine-125 brachytherapy for treating hepatic carcinoma is safe and minimally invasive,with a rapid recovery and a high survival rate.