Clinical Application Of Microwave Ablation Assisted Liver Resection

Objective: Research the clinical application of microwave ablation(MWA)in the process of laparoscopic and laparoscopic hepatectomy.Discuss the advantages and disadvantages of microwave technique in the application of liver resection.Observe the effect of microwave ablation on perioperative period of liver resection,And follow-up the effect of microwave on the long-term treatment of primary malignant tumors of liver.Evaluate the clinical value of microwave-assisted hepatectomy,and to provide clinical data for the clinical application of microwave ablation assisted hepatectomy.Methods:Retrospective analysis in January 2009 to January 2015 to the Beijing Air Force General Hospital of liver resection of 275 cases of liver lesions.Microwave group was treated with microwave ablation of liver resection group,including 166 cases of primary liver cancer,54 cases of hepatic hemangioma;The control group was non-microwave ablation of the liver resection group,including 109 cases of primary liver cancer,43 cases of hepatic hemangioma.66 cases of laparoscopic surgery,microwave group and control group were all primary liver cancer,of which 38 cases of microwave group,the control group of 28 cases.All final diagnoses were diagnosed by pathology.In the microwave group,intracranial ultrasonography was used to direct themicrowave ablation along the liver preconditioning line,and the liver tissue was formed into the coagulation necrosis zone on the liver tangent line,and then hepatic resection was performed on the hepatic coagulation necrosis band.The control group did not use the microwave assisted technique,Intraoperative partial use of hilar occlusion technology.Statistics of the two groups of patients preoperative basic situation,intraoperative bleeding,operation time,blocking the hilar conditions,abdominal drainage tube extraction time,postoperative complications,postoperative hospital stay,postoperative blood transfusion,Survival rate and so on.Through the comparison between the two groups,the different effects of microwave ablation on benign and malignant hepatectomy were evaluated,and microwave ablation has different effects on laparotomy and laparoscopic surgery.And analyze the effect of microwave ablation on short-term survival of patients.In addition,the microwave group of postoperative hospital stay was less than the control group,the difference was statistically significant.Laparotomy: the two groups were successfully completed the operation,no patients died.(P <0.05).The time of drainage in the microwave group was significantly lower than that in the control group(P <0.05).The time of drainage in the microwave group was significantly lower than that in the control group(P <0.05).The ratio of blood transfusion was 13.0% in the microwave group and 20.9% in the control group.The difference was statistically significant(P <0.05).Results: Laparoscopic surgery: The microwave group and the control group were successfully completed,no recurrence of laparotomy,no significant postoperative bile leakage and bleeding and other serious complications,which microwave group operation time was significantly less than the control group,the bleeding was significantly lower In the control group,the difference was statistically significant(P <0.05).The time of operation,intraoperative hemorrhage and drainage of the drainage group were lower than those of the control group,the difference was statistically significant(P <0.05).But there was no significant difference in total postoperative hospital stay(P> 0.05).Therewas no significant difference between the microwave group and the control group in the excision of liver segment(P> 0.05).The ratio of blood transfusion was 15.2% in the microwave group and 30.3% in the control group.The difference was statistically significant(P <0.05).The proportion of patients in the microwave group was lower than that in the control group.Laparotomy:The 1-year,3-year overall survival rates of the control group were 93.7% and 82.0%,respectively.The 1-year,3-year overall survival rates of the control group were 90.8% and 75.1%;Laparoscopic surgery:The 1-year,3-year overall survival rates of the control group were 95.0% and 88.0%,respectively.The 1-year,3-year overall survival rates of the control group were 92.9% and 82.1%;There was no significant difference between the two groups(P> 0.05).Conclusion:Microwave-assisted hepatectomy is a safer and more effective surgical procedure that can significantly reduce bleeding and oozing during intraoperative hepatic transection,shorten the operation time and reduce the risk of postoperative bile leakage.Because it can effectively control the liver cross-sectional bleeding,it can reduce the rate of laparotomy,clear surgical field of view and improve the safety of laparoscopic hepatectomy.It can reduce the perioperative complications of patients,especially,in patients with cirrhosis.It is worthy of clinical promotion and application?Microwave technology has no significant effect on its short-term survival rate in patients,but which can reduce perioperative complications and increase perioperative safety.When the liver mass near the blood vessels or bile duct,the operator not only need to have a wealth of surgical experience,but also have a good knowledge of anatomy and ultrasound technology.