Comparison Of Ultrasound Guided Laser Ablation And Radiofrequency Ablation In The Treatment Of Small Hepatocellular Carcinoma

Small hepatocellular carcinoma(HCC)refers to single nodules less than 3 cm or two adjacent liver nodules and the diameter of less than 3cm in diameter,its early diagnosis and treatment is the key measure to improve the quality of life and reduce the mortality.Now the surgical resection is the first choice for the treatment of small HCC,however,most of the patients accompany with the disease of hepatitis,liver cirrhosis and so on,which is not suitable to take the surgery,thus causing the widespread application of non-operation treatment in the small hepatocellular carcinoma.In recent years,with the progress of diagnosis and treatment technology,the early diagnosis rate of small hepatocellular carcinoma is getting higher,ablation of hepatocellular carcinoma in situ has gradually become the first choice for treatment of small hepatocellular carcinoma.Among these,radiofrequency ablation has the advantages of safe,reliable,easy to bear,and less complications and so on,when causing the death of the local hepatocytes,the normal form of the liver tissue was preserved.Because of these advantages,it is the first choice after surgical resection and liver transplanta tion.At the same time,laser ablation has been applied to the treatment of liver cancer as well.In this study,the efficacy and characteristics of ultrasound-guided laser ablation and radiofrequency ablation for small hepatocellular carcinoma were compared,thus finding the advantages and disadvantages of LA and RFA in the treatment of small HCC,and providing a more optimized treatment plan and data support for the clinical treatment of liver cancer.There are two parts as follows:Part 1:Ultrasound guided laser ablation was used to treat small hepatocellular carcinoma,and changes of therapeutic index were evaluated before and after laser ablation,analysis the effect of laser therapy in small hepatocellular carcinoma,recording of various complications.Thus laying the foundation fro the comparison of laser ablation and radiofrequency ablation.Part 2:On the basis of the first part,two groups of patients with small hepatocellular carcinoma were treated by laser ablation and radiofrequency ablation respectively.The evaluation indexes of the therapeutic effect of the two methods were compared,various complications were recorded,the advantages and disadvantages of laser ablation and radiofrequency ablation therapy of small hepatocellular carcinoma were analyzed.Part 1:Ultrasound-guided laser ablation for treatment of small hepatocellular carcinomaObjective To explore the clinical value of ultrasound-guided laser ablation in the treatment of small hepatocellular carcinoma.Methods A total of 31 lesions ablated with LA in 36 patients with small hepatocellular carcinoma were selected in jiangyin people's hospital from March 2013 to October 2015.After 1 month of the operation,the results of contrast enhanced ultrasound(CEUS)and serum alpha fetoprotein(AFP)were compared with the results of preoperative,and complications were counted,analysis of the effect of laser ablation in the treatment of small hepatocellular carcinoma.Results According to the results of contrast enhanced ultrasound,28 lesions were complete remission,3 lesions were partial remission and AFP were significantly lower than pretreatment.Postoperative adverse reactions were mild,manifested as abdominal pain(59.2%),fever(11.1%),nausea(44.4%),vomiting(18.5%),diarrhea(3.7%).Conclusion Utrasound-guided laser ablation can be a good option for treatment for small hepatocellular carcinoma,and the postoperative adverse reactions were mild.Part 2:Comparison of Ultrasound guided Laser Ablation and Radiofrequency Ablation in the Treatment of Small Hepatocellular CarcinomaObjective The aim of this trial was to compare the results obtained using laser ablation(LA)and radiofrequency ablation(RFA)to treat small hepatocellular carcinomas(HCC),analysis the advantages and disadvantages of laser ablation and radiofrequency ablation in the treatment of small hepatocellular carcinoma.Methods 93patients with small hepatocellular carcinoma were divided into laser ablation group(43 cases with 52 lesions)and the radiofrequency ablation group(50 cases with 57 lesions),the effect of treatment and serum alpha fetal protein(AFP)were compared,and the complications of the two groups were recorded.Results Contrast enhanced ultrasound revealed complete tumour ablation in 90.4%(47/52)patients treated with LA and 91.2%(52/57)of those treated with RFA,partial tumour ablation in 9.6%(5/52)patients treated with LA and 8.8%(5/57)of those treated with RFA;Serum alpha fetal protein(AFP)were significantly decreased in two groups(p<0.05),and there was no significant difference between the recovery cases of AFP in two groups(p>0.05);The incidence of minor complications was no significantly difference between the two groups(p<0.05),and the incidence of serious complication with RFA group was higher than LA group(p<0.05).Conclusion We found LA and RFA to be equally effective.However,LA was simple and the incidence of serious complication was lower than that of RFA.