ObjectiveTo investigate the safety and feasibility of fluorescent guided laparoscopic central hepatic tumor resection via anterior transhepatic approach. MethodWe retrospectively analyzed the clinical data of three patients who underwent fluorescent guided laparoscopic central hepatic tumor resection via anterior transhepatic approach in Department of Hepatobiliary and Pancreas Minimally Invasive Surgery of Hunan Provincial People’s Hospital from April 2017 to April 2020.ResultsAll the three patients completed the operation pure laparoscopically. Pathology results showed one case of hepatocellular carcinoma and two cases of focal nodular hyperplasia, the tumor size range from 4–7 cm. The operation time was 240–320 min, and the blood loss was 150–500 mL. There was no intraoperative blood transfusion. The postoperative hospital stay was 10–30 days. Postoperative bile leakage occurred in one patient, which was cured by laparoscopic hepatectomy. Three patients were followed up for 8, 36, and 25 months, respectively, and all the patients survived and there was no tumor recurrence up to november 2020.ConclusionsLaparoscopic resection of central hepatic tumor is difficult and risky. Anterior transhepatic approach can maximize the preservation of liver parenchyma. In hepatobiliary and pancreatic centers with high volume of laparoscopic hepatectomy, this method is safe and feasible after strict patient selection, accurate preoperative evaluation, and fine intraoperative skills. Indocyanine green fluorescence navigation technology is helpful to accurately locate tumor during operation.
Objective To study the results of in situ microwave thermocoagulation therapy for liver neoplasms. Methods Thirty-one patients (male 28, female 3) with liver neoplasms underwent in situ microwave thermocoagulation therapy in recent 4 years were studied. The time of the therapy arranged from 2 to 6 minutes with the core temperature from 110℃ to 125℃. Twenty six of the thirty one (83.9%) were followed up. Results Ninty point three percent of these patients have a good result. The average survival time after the operation was 19.7 months. One-year and three-year survival rate were 77.4% and 38.7%, respectively. Conclusion The in situ microwave thermocoagulation therapy have the advantages of causing slight trauma, promoting repair, good tolerance and curative effectiveness. It’s a simple, safe and effective method with less adverse effect for treating the liver neoplasms, especially for unresectable neoplasms.
To investigate the mRNA expression of nm23-H1 gene in human liver tumor. In tumor and corresponding nontumoral liver specimens from 20 patients, nm23-H1 mRNA were examined by reverse transcriptionpolymerase chain reaction (RT-PCR) method with specific primers. Results: The primers designed in this study could amplified nearly entire coding sequence of nm23-H1 gene. All the samples showed positive expression of nm23-H1 mRNA, indicating there was no expression loss or obvious alteration. Conclusions: The achievement of RT-PCR method lays foundation for quantitative gaugement of nm23-H1 mRNA in liver tumor.
ObjectiveTo summarize the experiences of precise liver resection for giant complex hepatic neoplasm. MethodsFifty-two cases of giant complex hepatic neoplasms were resected using precise liver resection techniques from April 2008 to August 2009. Hepatic functional reserve and liver imaging were evaluated before operation. Appropriate surgical approach, halfhepatic blood flow occlusion, new technique of liver resection, and intraoperative ultrasonography were applied during operation. ResultsThe mean operative time, halfhepatic blood occlusion time, blood loss, recovery of alanine aminotransferase, and total bilirubin were 350 min (210－440 min), 43 min (8－57 min), 370 ml (250－1 150 ml), 10 d (7－14 d), and 4.5 d (3－10 d), respectively. Only 6 patients had mild bile leakage. No liver failure and other major complications emerged, and no death happened. ConclusionPrecise liver resection is a safe and effective approach for giant complex hepatic neoplasm.
Objective To investigate the inhibitory effect of proliferation cell nuclear antigen (PCNA) antisense oligonucleotides mediated by liposome transfection on hepatocellular carcinoma cell proliferation. MethodsThe antisense oligonucleotides were complementary to 18mer sequences next to the start codon of PCNA mRNA sequences. The human hepatocellular carcinoma cell line Bel7404 was treated with antisense oligonucleotides. The inhibition of proliferation was estimated by MTT method. We compared the deference between the liposome mediated transfection technique and direct transfection technique. ResultsThe cell proliferation was inhibited effectively by antisense oligonucleotides. A sense sequence oligomer showed no effect.Liposome mediated transfection could enhance the inhibitory effect. Conclusion Liposome mediated transfection could enhance the inhibitory effect of PCNA antisense oligonucleotides on hepatocellular carcinoma cell proliferation.
目的探讨肝血管瘤切除术中血流阻断方法的选择。方法回顾性分析我院收治的19例肝血管瘤患者的手术方式。结果全组均行手术切除，术中出血50～1 500 ml（平均312 ml）。 术中根据血管瘤所在位置选择不同肝血流阻断方法，其中行半肝血流阻断4例，运用Glisson蒂横断式肝切除术或其分段原理阻断Glisson系统分支6例，间断阻断第一肝门7例，预置肝上、下下腔静脉和第一肝门阻断带并间断阻断第一肝门2例。 术后5例并发右侧胸腔积液，均经保守治疗后好转，手术并发症发生率为26.3%（5/19）。 术后住院7～41 d（平均16.9 d），均治愈出院。12例患者获随访，随访0.3～2年（平均1.1年），术前有症状的8例患者症状均消失，无复发，1例残留肝内血管瘤（直径lt;2 cm）。结论肝血管瘤患者肝切除术中的入肝血流阻断应强调个体化，根据肿瘤位置及大小选择不同的阻断方法，使患者术中出血少，术后恢复快。
Objective To evaluate the role of contrastenhanced CT (CECT) scanning in the diagnosis and treatment planning of some rare liver tumors. MethodsWe retrospectively reviewed the CECT imaging features of 10 cases with rare tumors of the liver proved by surgical pathology in 8 cases or by liver biopsy in 2 cases, with correlation of relevant clinical manifestations, laboratory results and surgical findings. ResultsThree cases were histopathologically proved to be benign, and 7 cases were malignant. On CT images, the liver lesions were mixed cysticsolid in 5 cases, totally solid in the other 5. Eight cases demonstrated heterogeneous enhancement, while 2 cases of liver lymphoma had no enhancement. The anatomic relationship of tumors to intrahepatic vasculature, the compression and infiltration of neighboring abdominal structures were accurately delineated by CT as compared with findings at operation. Clinical manifestations and laboratory findings were not useful for the qualitative diagnosis of rare liver tumors, except for hepatocellular carcinoma. ConclusionCECT is very useful for the detection of rare liver tumors and the fine depiction of local extent of these tumors. When correlated with clinical and laboratory information, it helps to differentiate rare liver tumors from hepatocellular carcinoma. But its role in the characterization of rare liver tumors is limited.