| Objective: The aim of this study was to compare the safety and efficacy of laparoscopic microwave ablation(LMWA)and percutaneous microwave ablation treatment(PMWA)in treating hepatocellular carcinoma(HCC).Methods: A retrospective analysis of sichuan province people's hospital during July 2014 to July 2017 in Hepatobiliary and Pancreatic Center for the first time in the diagnosis of primary liver cancer,date from patients with HCC nodules who had undergone either laparoscopic microwave ablation(LMWA)or percutaneous microwave ablation(PMWA),a total of 67 cases,according to the surgical treatment in a different way,it can be divided into percutaneous microwave ablation group 41 cases and laparoscopic microwave ablation group of 26 patients.A stratified study of 67 patients was divided into diameter>3.0cm and diameter?3.0cm groups according to the diameter of the tumor.The patients in the group were diagnosed according to the standard of diagnosis and treatment of primary liver cancer.The patients with preoperative data(sex,age,hemoglobin,serum transaminase,AFP,merge disease,tumor size and number),intraoperative data(operation time,intraoperative of tumor size and number,intraoperative complications),postoperative data(postoperative hospitalization time,hospitalization cost and reoperation)were to statistical analysis.Results: 1.There was no significant difference in the general data(sex,age,hemoglobin,aminotransferase,AFP,liver function grade,and merge disease)between LMWA and PMWA(P>0.05).The new lesions were found in the LMWA(21/53)and the PMWA(1/43),was statistically significant(P<0.05).The incidence of hemorrhage in the PMWA(7/41)and LMWA(0/26)was statistically significant(P<0.05).PMWA and LMWA in totalcomplications,postoperative pain,syndrome after ablation,diaphragmatic muscle injury,planting transfer,burns skin,infections,biliary tract injury,gastrointestinal perforation,and perioperative death had no statistical significance(P>0.05).2.Diameter>3.0 cm group and diameter?3.0 cm group preoperative general information(sex,age,hemoglobin,transaminase,AFP,liver function grade,merge disease)is no statistical difference(P>0.05).The ablation time of patients in diameter ? 3.0cm group(15.14 1.843min)and diameter>3.0cm group(21.50 2.199min)was statistically significant(P<0.05),but there was no statistical difference in operative time,number of newly discovered tumors and newly discovered tumor number(P>0.05).Two groups of patients after total complications,postoperative pain,syndrome after ablation,diaphragmatic muscle injury,planting transfer,burns skin,infections,biliary tract injury,gastrointestinal perforation,and perioperative death had no statistical significance(P>0.05).3.There was no significant difference in the time of hospitalization,hospitalization expenses and reoperation between LMWA and PMWA(P>0.05).4.Three months after operation,the recurrence rate was 3/38,4/38,6/38 in PWMA.The recurrence rate in the three months after LMWA was 3/25,3/25,5/25,respectively.There was no significant difference in recurrence rate between the two groups(P>0.05).5.Diameter>3.0 cm group three months postoperatively in patients with recurrence in patients with 4/27,5/27,8/27,respectively,the diameter?3.0 cm group with three months of recurrence after 2/36,2/36,3/36,respectively,two groups of patients with recurrence rate in the third month was statistically significant(P<0.05).Conclusion: 1.Laparoscopic microwave ablation and percutaneous microwave ablation are the safe and effective surgical methods for the treatment of primary liver cancer.2.The detection rate of microcarcinoma during laparoscopic microwave ablation is higher than that of percutaneous microwave ablation.3.Laparoscopic microwave ablation is more effective in controlling bleeding after ablation than percutaneous microwave ablation.4.For patients with tumor diameter >3.0cm,the recurrence rate after microwave ablation is high.For these patients,appropriate surgical methods should be selected for treatment. |
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