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[目的]探讨第二肝门区肝癌射频消融的治疗结局。[方法]2006年1月～2008年1月26例第二肝门区肝癌患者的32个肿瘤接受了35次超声引导下经皮穿刺射频消融。[结果]26例患者初次射频消融第二肝门区肿瘤30个,22例患者的25个肿瘤完全消融,完全消融率84.6%。<3cm、3～4cm和>4cm的肿瘤完全消融率分别为91.3%、66.7%和0,差异有显著性(P=0.027)。26例中的9例因局部肿瘤残留、复发、新生等原因接受多次射频消融,26例患者共接受35次射频消融,32个肿瘤中完全消融29个,总体完全消融率90.6%(29/32)。无射频相关死亡发生,2例发生明显胸水,1例发生胆脂瘤并发肝内感染,3例发生局部复发。全组5例死亡,总体存活率80.8%。1年总体生存率86.7%,1年无复发生存率为71.4%。[结论]在熟知第二肝门区解剖特征、射频消融操作水平较好的情况下,射频消融治疗第二肝门区肝癌疗效确切、安全可靠。
[Objective] To investigate the therapeutic outcome of radiofrequency ablation in the second hilar region of liver cancer. [Method] Twenty-two tumors of 26 HCC patients from January 2006 to January 2008 underwent radio frequency ablation under the guidance of ultrasound. [Results] Twenty-six patients underwent radiofrequency ablation of 30 tumors in the second hilar region. Twenty-five of 25 patients underwent complete ablation and the complete ablation rate was 84.6%. Complete tumor ablation rates of <3cm, 3 ~ 4cm and> 4cm were 91.3%, 66.7% and 0 respectively, with significant difference (P = 0.027). Nine of 26 patients underwent multiple radiofrequency ablation due to residual tumor, recurrence, and newborn. Twenty-six patients received 35 radiofrequency ablations, 29 of 32 tumors were completely ablated, and the overall complete ablation rate was 90.6% (29 / 32). No radiofrequency death occurred, 2 cases had obvious pleural effusion, 1 case had cholesteatoma complicated with intrahepatic infection, and 3 cases had local recurrence. The whole group of 5 patients died, the overall survival rate of 80.8%. The overall 1-year survival rate was 86.7% and the one-year recurrence-free survival rate was 71.4%. [Conclusion] With the familiar anatomic features of the second hilar region and the good radiofrequency ablation operation, radiofrequency ablation for the second hilar hepatocellular carcinoma is effective and safe.