Clinical Efficacy of Laparoscopic Microwave Ablation in the Treatment of Small Hepatocellular Carcinoma with Cirrhosis / 中国微创外科杂志

ABSTRACT

Objective To evaluate the efficacy of microwave ablation in the treatment of small hepatic carcinoma with liver cirrhosis.Methods Altogether 50 patients with small hepatic carcinoma with liver cirrhosis from April 2009 to June 2013 were divided into microwave ablation group (n =26) or resection group (n =24).The microwave ablation group was treated by laparoscopic microwave ablation while the resection group was treated by laparoscopic resection.The time of operation,intraoperative blood loss,length of hospital stay,postoperative complications,postoperative liver functions,and 1-year,2-year,3-year survival rate of each group were observed.Results The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were increased and the albumin (ALB) was decreased postoperatively in both groups,and all recovered in 7 days after operation.The ALT and AST in microwave ablation group were lower than resection group,and the ALB was higher than resection group,with statistical significances (P ＜ 0.05).The operation time in microwave ablation group was (53.5 ± 8.5) min,significantly less than the resection group [(92.9 ± 19.8) min,t =-9.019,P =0.000].The intraoperative blood loss in microwave ablation group was (41.9 ± 17.2) ml,significantly less than the resection group [(131.3 ± 66.0) ml,t =-6.663,P =0.000].The length of hospital stay in microwave ablation group was (7.8 ± 1.0) d,significantly less than the resection group [(10.4 ± 1.3) d,t =-7.742,P =0.000].The rate of postoperative complication in microwave ablation group was 19.2％ (5/26),significantly less than the resection group [45.8％ (11/24),x2 =4.059,P =0.044].The 1-year,2-year,and 3-year survival rates in microwave ablation group were 100％,88.5％,80.8％,respectively,and those in resection group were 100％,91.7％,83.3％,respectively.There were no statistical differences between the two groups (log-rank x2 =0.077,P =0.792).Conclusions Microwave ablation therapy is feasible in the treatment of small hepatocellular carcinoma with cirrhosis that located in the special area and endoscopic surgery is not easy to remove.Microwave ablation has advantages of less trauma,simple performance and less complications.