人工腹水是可行的，有效的难烧蚀肝癌

StephenW

Review Article

Hepatology International

October 2015, Volume 9, Issue 4, pp 514-519

First online: 25 June 2015
Artificial ascites is feasible and effective for difficult-to-ablate hepatocellular carcinoma

    Chia-Chi Wang , Jia-Horng Kao
Author Affiliations

        1. Department of Gastroenterology and Hepatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan
        2. Graduate Institute of Clinical Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, 7 Chung-Shan South Road, Taipei, 10002, Taiwan




Abstract

Hepatocellular carcinoma (HCC) is the second leading cause of cancer death worldwide. Curative treatments for early-stage HCC include local ablation, hepatic resection, and liver transplant. Radiofrequency ablation (RFA) is a minimally invasive treatment and can be used in patients who have an increased risk of hepatic resection, including a liver reserve of Child-Pugh B status and suboptimal general condition. However, a difficult location of HCC can interfere with the performance of RFA because of a conspicuous lesion, poor electrode path, or increased risk of thermal injury to adjacent organs. Difficult locations include tumors abutting the diaphragm or near vital organs such as the gastrointestinal tract and gallbladder. Because artificial ascites can provide an improved sonic view and protects adjacent vital organs from thermal injury, it widens the indication of RFA in the treatment of HCC. The systemic review showed that the technique of artificial ascites has a high success rate (>90 %) without the clear appearance of severe adverse events such as intraperitoneal hemorrhage or gastrointestinal perforation. The risk of intraperitoneal seeding is not increased. In addition, the therapeutic effectiveness, such as the complete ablation rate or local tumor progression rate, remains satisfactory for difficult-to-ablate HCCs. In conclusion, RFA after infusion of artificial ascites is feasible and effective for difficult-to-ablate HCCs. However, because data on the local tumor progression rate, heat-sink effect, and intraperitoneal seeding are scarce, additional studies are required.
Keywords
Artificial ascites Hepatocellular carcinoma (HCC) Radiofrequency ablation (RFA)
Hepatology International Hepatology International Look

StephenW

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肝病国际

2015年10月，第9卷，第4期，第514-519

首先在线：2015年6月25日
人工腹水是可行的，有效的难烧蚀肝癌

    林嘉绮王贾泓花王
作者机构

        胃肠病学和肝病，台北慈济医院，佛教慈济医学基金会的1系和医学，慈济大学，花莲，台湾的学校
        临床医学2.研究所和肝炎研究中心，医学和医院，仲山南路7，台北，10002，台湾国立台湾大学




抽象的

肝细胞癌（HCC）是癌症死亡的第二大原因世界范围内。对于早期肝癌疗效的治疗包括局部消融，肝切除和肝移植手术。射频消融（RFA）是一种微创治疗，可在谁拥有肝切除的风险增加，包括Child-Pugh分级B状态和次优的总体状况进行肝脏储备患者使用。然而，肝癌的困难位置就可以与射频消融，因为当眼病变的表现，穷极路径，或热损伤周围脏器的风险增加干扰。艰苦地区包括肿瘤紧靠隔膜或接近重要器官如胃肠道和胆囊。因为人工腹水可以提供一种改进的声波视图和保护相邻生命器官免受热损伤，它扩大RFA在肝癌的治疗的指示。该系统的审查表明，人工腹水的技术具有很高的成功率（> 90％）没有明确的外观严重不良事件，如腹腔出血或消化道穿孔。腹腔接种的风险不增加。此外，治疗的有效性，如完全消融速率或局部肿瘤进展率，仍然令人满意对于难以烧蚀肝细胞癌。总之，RFA注入人工腹水后是可行的，有效的难以消融肝癌。但是，因为在本地肿瘤进展速率，受热效应，和腹膜播种的数据很少，另外的研究是必需的。
关键词
人工腹水肝癌（HCC）射频消融（RFA）
肝病国际肝病放眼国际

灿兴抗癌

这个人工腹水我在10年微波时准备做的也是考虑防止气胸，是需要到他们那（南京鼓楼医院）做。后来由于离家太远不方便就请周主任到我们本地没有用灌水做了。所幸没有出现气胸。只是把我疼的大半条命没了----终于知道为什么有的人说（做其他一些治疗）宁愿死也不做这句话了。

灿兴抗癌

回复 hy49 的帖子

没有烧到膈肌，而是在插微波刀的时候由于肝硬化的地方较多，捣鼓了好多次插不到位置后来另找个地方插的。所以很疼