| Objective:Radiofrequency ablation was performed in local resection of cirrhotic liver cancer,compared with non-radiofrequency ablation hepatectomy in this study,clinical parametersin was compared in order to demonstrate the superiority of combined therapy.Methods:36 patients with liver cirrhosis underwent radiofrequency ablation-assisted hepatectomy and 52 patients underwent non-radiofrequency ablation hepatectomy in the Department of Hepatobiliary surgery of the first affiliated Hospital of Nanchang University from September 2015 to September 2018 were analyzed retrospectively.The intraoperative bleeding,hilar occlusion time,postoperative liver function recovery,postoperative prothrombin time,postoperative complications,postoperative recurrence and incisal margin recurrence were compared between the two groups.Results:88 patients were enrolled in the study,including 36 cases of radiofrequency ablation assisted hepatectomy(40.9%)and 52 cases of non-radiofrequency ablation assisted hepatectomy(59.1%).There were 71 males and 17 females.There was no significant difference in sex,age,HBsAg,HBV-DNA replication,liver hardness,number of tumors,tumor location,tumor size,AFP,Child-Pugh grade,pathological classification and microvascular invasion between the two groups.There was no significant difference in prothrombin time and blood routine(white blood cell count,red blood cell count,hemoglobin,platelet count)between the two groups pre-and post-operation(P > 0.05).There was no significant difference in liver function preoperation,but on the first day postoperation,the levels of ALT(110.19±70.25vs137.23 ±47.05)and AST(130.31 ±64.54vs166.44 ±49.59)in radio-frequency group were significantly lower than those in non-radiofrequency group(P< 0.05).Both groups of patients successfully completed hepatectomy,and postoperative pathology confirmed that there was no tumor cell residue at the resection margin.The average intraoperative blood loss in radio frequency group(125.56 ±106.57)ml,non-radiofrequency group(221.06 ±206.86)ml,was significantly higher than that in non-radiofrequency group(P < 0.05).The average hepatic hilar occlusion time in radiofrequency group was 10.19 ±12.63 min,and26.15 ±9.95 min in non-radiofrequency group,there was significant difference between the two groups(P < 0.05).The average operation time in the non-radio frequency group was(100.87 ±38.51)min,and the average operation time in the radio frequency group was(106.81 ±33.41)min.There was no significant difference between the two groups(P > 0.05).There was no significant difference in the average postoperative hospital stay between the two groups.No treatment-related deaths in this study.There was significant difference in the incidence of postoperative complications between the two groups(P < 0.05),including biliary fistula(n = 2),pleural effusion(n = 2),refractory ascites(n = 3),bleeding(n = 2),biliary fistula(n = 4),pleural effusion(n = 6),refractory ascites(n = 8)and gastrointestinal bleeding(n = 1).There was no statistical difference in recurrence condition,recurrence time and recurrence mode between the two groups,but there was a statistical meaning in the mode of intrahepatic recurrence,the recurrence rate of incisal margin in the surgery combined with radiofrequency ablation group was significantly lower(p = 0.022).There was no significant difference in total survival time between the two groups(p=0.867).Conclusion:The results of this study show that the use of radiofrequency preconditioning in the local resection of cirrhotic liver cancer can achieve a good clinical effect,reduce intraoperative bleeding and hilar occlusion time,have little effect on the liver function of the patients and reduce incisal margin recurrence.It is a safe and effective method for hepatectomy for liver cirrhosis and liver cancer,and is worthy of further application. |
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