Clinical Study Of Ultrasound-guided Radiofrequency Ablation In The Treatment Of Malignant Tumors Of The Caudate Lobe Of Liver With Diameter ? 5Cm

Objective:To investigate the feasibility and value of ultrasound-guided percutaneous radiofrequency ablation in the treatment of malignant tumors of the caudate lobe of the liver with diameter ? 5cm.Methods:Retrospective analysis of clinical data of 54 patients with surgical treatment of hepatic caudate lobe with diameter ?5cm from October 1st,2016 to October 31 st,2018,Zhengzhou University Affiliated Tumor Hospital.Among them,30 patients underwent percutaneous radiofrequency ablation(RFA)(a total of 31 lesions)(set to RFA group),24 patients underwent laparoscopic liver resection(set to control group).Preoperative enhanced CT or enhanced MRI were performed to determine the location of liver tumor;and the data of the two groups were recorded and analyzed: preoperative condition:the gender,age,tumor size,liver function(TB?ALT?AST),;operative condition: operation time;postoperative condition : complication rate,liver function recovery,hospital stay and follow-up,etc.Results:1.All patients in the study group underwent enhanced CT or enhanced MRI before surgery.The results showed that the tumor size of RFA group was(2.25 ±0.75)cm,.The tumor size of control group was(2.61 ±0.59)cm.2.There were no statistically significant differences in age,gender,and tumor size between the RFA group and the control group(P>0.05).The preoperative biochemical test indexes(TB ?ALT?AST)of two groups were no statistical significance(P>0.05).The RFA group has shorter operation time than control group(p < 0.05).The postoperative liver function recovery time and hospital stay in RFA group were shorter than those in control group(p < 0.05).,There was no significant difference in postoperative tumor residue(P > 0.05),There was no significant difference in the overall complications(pain,fever,bile leakage,bleeding,infection,jaundice,postoperative effusion)between the RFA group and the control group(4/30 vs.7/24,p > 0.05).3.At the first month after RFA,conventional enhanced CT or enhanced MRI showed that 29 out of 31 lesions were completely ablated(complete response,CR)and 2 lesions were incomplete ablation(incomplete response,ICR),The diameters of these two incomplete ablation lesions were 3.5cm and 3.7cm respectively.ICR lesions were then treated with remedial RFA).After reexamination,all the original lesions reached CR.4.All patients in the study group were followed up by telephone or clinic,with an average follow-up of 5 months to 29 months.During the follow-up period,no deaths occurred.Conclusions:Percutaneous radiofrequency ablation guided by ultrasound is safe and feasible in the treatment of malignant tumors of the caudate lobe of the liver with diameter ? 5cm,and its short-term effect is similar to that of traditional hepatectomy.Percutaneous radiofrequency ablation with ultrasound-guided percutaneous radiofrequency ablation for malignant tumors of the caudate lobe of the liver can reduce the trauma,accelerate liver function recovery in patients,shorten the hospitalization time,without increasing the incidence of postoperative complications.