| Objective:To compare percutaneous microwave coagulation therapy and surgical resection in the treatment of 3-5cm isolated colorectal liver metastases,to investigate which treatment is the better therapeutic effect for 3-5cm isolated colorectal liver metastases.Method:Retrospectively analysis 74 cases of isolated colorectal liver metastases with diameter between 3 and 5cm from September 2010 to November 2013 in Department of hepatobiliary surgery,Liaoning Cancer Hospital,the 36 months follow-up results were analyzed.In this study,74 subjects were divided into percutaneous microwave coagulation therapy group and surgical resection group,including 31 cases and 43 subjects,according to the different surgical treatment options.The data were collected from 74 patients,including gender,age,maximum diameter of liver metastases,ChildPugh classification of liver function,time of liver metastasis,location of primary tumor,differentiation degree of primary tumor.Percutaneous microwave coagulation therapy group: the use of cold cycle microwave ablation therapy instrument for patients with microwave ablation therapy,intraoperative use of color doppler ultrasound for real-time monitoring to ensure that metastatic treatment of radical treatment.Surgical resection group: in the guarantee of negative margins under the premise of partial liver resection options include regular liver segment,lobectomy and irregular liver metastases resection.Surgery according to the location of metastases,bleeding is expected to how much for the liver block or hepatic portal block.Through the analysis of the clinical data and followup results of the two groups of patients,the effects of local treatment,cumulative survival rate,recurrence rate,postoperative complications and the time of treatment of metastatic treatment were compared in the percutaneous microwave coagulation therapy group and the surgical resection group,From the time of admission to the length of the hospital,the patient's medical expenses during hospitalization.For measurement data were expressed as ?X±S(mean ± standard deviation),comparison between groups using t test;the measurement data of the normal distribution,count data to rate(%),were expressed as the median combination range ?2 test,survival analysis using Kaplan-Meier method,using log-rank test to compare the survival curve differences.P <0.05 was statistically significant.Result : In this study,the two groups of patients with local treatment contrast: percutaneous microwave coagulation therapy in 31 patients in 30 cases of liver metastases after ablation to achieve complete ablation,1 case of liver metastases ablation,the first complete ablation rate of 96.8%,surgery Of the 43 patients,41 patients had complete resection of liver metastases,2 cases had recurrence,radical resection rate was 95.3%,P> 0.05,the difference was not statistically significant.The cumulative survival rate and recurrence rate of the two groups were 96.8%,78.9%,47.4%,9.7%,29.6% and 52.0% at 12,24 and 36 months after microwave coagulation coagulation therapy.The cumulative survival rate and recurrence rate were 95.3%,71.7%,49.6%,11.6%,27.0% and 56.8% respectively in the surgical resection group at 12,24 and 36 months respectively.The P values were 0.759,0.567,0.515,0.790,0.819,0.712.Therefore,there was no significant difference in cumulative survival rate and recurrence rate between the two groups at 12,24,and 36 months after operation(P>0.05).The incidence of complications in the two groups was: pleural effusion(1 case of microwave ablation group,3 cases of surgical resection group),incision infection(1 case of microwave ablation group,3 cases of surgical resection group),hepatic abscess 1 case,surgical resection group 2 cases),and in the lung infection,abdominal hemorrhage,liver failure these complications,microwave ablation group did not occur in one case,surgical resection group were 2 cases,2 cases,1 case.The incidence of complication in microwave coagulation therapy group and surgical resection group was 9.7% and 30.2% respectively.The incidence of different types of complications was significantly different between the two groups.The incidence of percutaneous microwave coagulation therapy was significantly lower than that of the surgical resection group,P= 0.034,the difference was statistically significant(P <0.05).The average operative time(46.5 ± 16.7)min in the microwave coagulation therapy group was significantly shorter than that in the surgical resection group(163.0 ± 53.4)min(P <0.05).The length of hospital stay was(6.1 ± 1.9)d and(12.1 ± 7.1)d(P <0.05),respectively.The cost of treatment was(3.1 ± 0.6)million in the microwave coagulation therapy group,which was significantly lower than that in the surgical resection group(5.9 ± 0.9)(P <0.05).Conclusion : 1,For patients with diameter of 3-5cm isolated colorectal liver metastases,percutaneous microwave coagulation therapy and surgical resection of the recent effect is quite.2,Percutaneous microwave coagulation therapy of 3-5 cm diameter of isolated colorectal cancer patients with liver metastases compared with surgical resection,the patient's surgery time is shorter,the incidence of complications is low,shorter hospital stay,the economic burden is lighter.3,Percutaneous microwave coagulation therapy may be considered as one of the first choice for the treatment of patients with diameter of 3-5cm isolated colorectal liver metastases. |
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