The Research Of The Safety And Efficacy Of LUS-guided RFA For Primary Liver Cancer

Objective 1.To explore the technical points of laparoscopic ultrasound guided LRFA therapy for primary liver cancer,and to evaluate the safety and effectiveness of laparoscopic ultrasound guided radiofrequency ablation of primary liver cancer compared with PRFA therapy guided by Real-time Virtual Sonography.2.To explore the difference of radiofrequency ablation therapy with different guiding methods and the application value of different radiofrequency ablation methods in the treatment of primary liver cancer.Methods A retrospective analysis was used to study a total of 74 liver cancer nodules from 60 patients with primary liver cancer who were treated in the Department of Hepatobiliary Surgery of Chifeng Clinical Medical College of Inner Mongolia Medical University from January 2017 to December 2018.According to the different operation methods,the patients were divided into LUS group and RVS group.In LUS group,there were 30 patients with 41 nodules of primary liver cancer,and there were 30 patients with 33 nodules in RVS group.The patients in LUS group were treated with LRFA under the guidance of laparoscopic ultrasound,patients in RVS group were treated with PRFA guided by Real-time Virtual Sonography.Follow-up was performed after operation.The average operation time,the proportion of newly found lesions during operation,the safe boundary of ablation,the primary effectiveness rate,the changes of liver founction(postoperative liver enzymes and bilirubin),postoperative hospital stay,complications,recurrence rate and overall survival rate were compared between the two groups.Result All patients in both groups completed the operation successfully.Radiofrequency ablation was successfully performed in all 74 primary liver cancer nodules.The average operation time in LUS group was longer than that in RVS group[(82.13±38.20)min vs(50.53±8.04)min].The difference was statistically significant(P<0.05).6 new lesions werefound during the operation in the LUS group,accounting for 14.63% of the total number of treatments,and there was no new focus in the RVS group.And the difference between the two groups was significant(P<0.05).The average safe boundary after ablation in LUS group was significantly lager than that in RVS group [(1.36±0.18)cm vs(1.24±0.11)cm],and the difference was statistically significant(P<0.05).The primary effectiveness rate in the LUS group was 95.12%(39/41)and 93.94%(31/33)in the RVS group,and there was no significant difference between the two groups(P>0.05).The changes of glutamic pyruvic transaminase(ALT)[(26.10±4.49)vs(23.22±3.73)] and indirect bilirubin(IBIL)[(2.24±0.71)vs(1.90±0.59)] in LUS group were significantly higher than those in RVS group,and all the differences were statistically significant(P<0.05).There was no significant difference in postoperative hospital stay [(7.93±2.60)d vs(8.20±2.00)d],postoperative complications,recurrence rate within 1 year[6.67%(2/30)vs 10.00%(3/30)] and 1-year overall survival rate[100%(30/30)vs 100%(30/30)] between the two groups(P>0.05).Conclusion LUS-guided LRFA therapy and RVS-guided PRFA therapy are both effective radiofrequency ablation methods.LUS-guided LRFA therapy can find small,occult lesions and new lesions during operation,with larger safe boundary and more thorough ablation.RVS-guided PRFA treatment has advantages in puncture guidance,surgical convenience,surgical trauma and so on.Choosing a suitable radiofrequency ablation method for different cases can improve the therapeutic effect of radiofrequency ablation.