Analysis of recurrent hepatocellular carcinoma treated by microwave ablation assisted by three-dimensional visualization / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To evaluate the clinical efficiency and feasibility for the treatment of recurrent hepatocellularcarcinoma treated by percutaneous microwave ablation assisted by three-dimensional visualization.METHODS: Theclinical data of 84 consecutive patients with recurrent hepatocellular carcinoma treated by percutaneous microwaveablation in Department of Interventional Ultrasonography,Chinese PLA General Hospital from December 1, 2017 to June1, 2019 were analyzed retrospectively. The patients were divided into three-dimensional reconstruction group(30 patients,49 tumors)and normal group(54 patients,111 tumors)according to whether evaluated by three-dimensionalvisualization. Treatment related indicators and the prognosis were compared. Preoperative total liver volume,tumorvolume,planning ablation volume,postoperative total liver volume and ablation volume were computed via three-dimensional visualization system in three-dimensional reconstruction group. Furthermore,the preoperative planningablation volume and actual postoperative ablation volume were compared between the two group.RESULTS: All patientsaccomplished the procedure of percutaneous microwave ablation. The maximal diameter of tumor was(4.3±1.0)cm,andthe follow-up period was 10(2-19) months. The three-dimensional reconstruction group and normal group had nosignificant differences in major complications rate(6.7% vs. 9.3%), overall survival rate(100% vs. 94.4%), intrahepaticdistant recurrence rate(8.2% vs. 12.6%) and local tumor progression rate(6.1% vs. 10.8%)(P>0.05). There was nostatistically significant difference between preoperative planning ablation volume and postoperative ablation volume inthe two groups(P=0.616). The ratio of residual liver volume/standard liver volume was(98.0±25.6)%. Alanine aminotransferase,aspartate amino transferase,total bilirubin and cholinesterase had no statistically significant difference before and after ablation between two groups(P>0.05).CONCLUSION: The role of ultrasound-guidedpercutaneous microwave ablation assisted by three-dimensional visualization for the accurate treatment of recurrent hepatocellular carcinoma is of great importance.