The auxiliary application strategy of radiofrequency ablation in laparoscopic anatomical hemihepatectomy / 中华肝胆外科杂志

ABSTRACT

Objective:To analyze the auxiliary application strategy and efficacy of radiofrequency ablation (RFA) in laparoscopic anatomical hemihepatectomy (LAH).Method:The clinical data of consecutive patients who underwent RFA-assisted LAH from 5 hospitals including Beijing Chaoyang Hospital, Capital Medical University between January 2016 and January 2020 were retrospectively reviewed.Results:Among the 32 patients, there were 21 males and 11 females. The age range is 32 to 77 years, with a median age of 52 years. There were 18 cases of hepatocellular carcinoma, including 16 cases of single lesion and 2 cases of two lesions, with the maximum tumor diameter of (5.6±1.2) cm. There were 12 cases of metastatic liver cancer, including 8 cases of single lesion, 3 cases of two lesions, 1 case of three lesions, and the maximum tumor diameter (4.7±1.6) cm. Primary hepatolithiasis 2 cases. Right hemihepatectomy was performed in 23 cases and left hemihepatectomy in 9 cases. No conversion to laparotomy. The operation time of right hemihepatectomy was (310.0±22.0) min, and left hemihepatectomy was (285.0±25.0) min. Intraoperative hemorrhage (330.0±28.0) ml. No patients received intraoperative infusion of human red blood cell suspension. Postoperative reactive pleural effusion occurred in 6 cases, biliary fistula in 3 cases, wound infection in 1 case, and cross section effusion in 1 case, all of which recovered after conservative treatment. No postoperative abdominal bleeding and liver insufficiency. Postoperative hospital stay (9.5±3.2) d. The follow-up time was 1-42 months, and the median follow-up time was 20 months. During the follow-up period, 17 (56.7%) of the 30 patients with malignant tumor experienced tumor recurrence, no sectional tumor recurrence, and no death.Conclusions:RFA has a variety of auxiliary applications in LAH, including prevention and treatment of liver cancer rupture during mobilization of liver, treatment of small bleeding blood vessels during liver transection, and help in securing safe and adequate resection margins.