New technology for treatment of liver cancer

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Liver cancer has a high incidence in our country, it is not only difficult to treat, expensive, and the effect is not ideal, known as "the k

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Liver cancer has a high incidence in our country, it is not only difficult to treat, expensive, and the effect is not ideal, known as "the king of cancer," said. In recent years, after painstaking research scientists, the treatment of liver cancer has made great progress, many patients from "dead" to "rule", from "cure" to "cure", the 5 year survival rate from 20 2.6% years ago to more than 20.6%. In addition to the improvement of surgical techniques, it is due to the development of minimally invasive technology. Through more than 10 years of hard exploration and practice, we introduce, summarize and improve a set of unique surgical treatment and minimally invasive treatment methods.

Surgical resection of hepatocellular carcinoma

Surgical resection is still the best curative effect of various treatment methods. All liver cancer diagnosis is clear, liver function is good, the tumor may be removed, should be treated as early as possible radical resection. Recently, our hospital from Germany to introduce the world's most advanced liver resection equipment Cusa (ultrasonic suction knife) and TissueLink (no blood scalpel), so that the accuracy and efficacy of surgery has been greatly improved. The traditional hepatectomy must be pre hepatic portal occlusion (i.e. hepatic blood circulation) to be performed, liver cells caused by ischemia often causes postoperative liver function recovery time is prolonged, and some even cause liver failure, or lead to other complications. The use of Cusa (ultrasonic aspirator knife) and TissueLink (no blood lancet) for hepatic resection without blocking hepatic portal not only, but also greatly improve the accuracy of operation, greatly reduce the possibility of residual cancer cells during operation, significantly improve the curative effect of natural. The current master of this new technology to the hospital are few, our department at the leading level in this field (for details please refer to the section "surgical treatment of liver cancer with new weapons: Cusa and TissueLink).

Two, liver cancer liver transplantation

Organ transplantation is one of the great achievements of the development of human medicine in twentieth Century, liver transplantation as a representative of organ transplantation, is one of the most sophisticated operation today in the field of surgery, known as the "summit of medicine", to save the only effective way for end-stage liver disease, liver transplantation is a symbol of modern medical science and technology and the development of hospital comprehensive strength. As one of the large-scale comprehensive hospitals in Beijing, our hospital set up a specialized liver transplantation center in 2004. Since its inception, the company has successfully implemented liver transplantation for many patients with severe liver disease and saved their lives. The center of difficulties in technology, especially the Yongpangaofeng, many times to rescue patients with severe hepatitis, hepatic coma, and achieved success, get with praise.

Our center has non bioartificial liver support system is the most advanced, cardiopulmonary bypass equipment and autologous blood transfusion equipment, special surgical instruments and materials of a full set of liver transplantation, adequate postoperative monitoring and treatment equipment, can be described as Goods are available in all varieties. Our hospital has many advanced equipment and facilities and means (such as 16 CT, PET, magnetic resonance imaging, color Doppler, etc.), create favorable conditions for the diagnosis and treatment of patients with liver transplantation, preoperative and postoperative. Our hospital has the most advanced modern operation room, can be carried out at the same time 5 liver transplantation. There are 7 special vehicles for transplantation, of which the ambulance of the 4, full-time responsible for the transfer of patients. We have a comprehensive follow-up system, which has been connected with the international network of liver transplantation.

At present we have successfully completed 50 cases of living donor liver transplantation in 172 cases of modified piggyback liver transplantation, classic liver transplantation. In all cases, the maximum age is 72 years old, the youngest is 14 months, the operation of skilled, part of the patients after liver transplantation, less bleeding, no blood transfusion, at least one case of bleeding only 100ml. My center specializes in severe hepatitis, acute liver failure, liver transplantation treatment, many successful rescue of such patients with severe life. Liver transplantation, liver and pancreas transplantation, combined liver and kidney transplantation, and so on. Since 2004, more than 200 cases of liver transplantation have been performed in our center. No operative death occurred. The success rate was 100%. The 1 year survival rate of liver transplantation was more than 90%, and the survival rate was 5 70%~85%.

Three, minimally invasive treatment of liver cancer

Due to the presence of a large number of liver cancer found in the advanced stage, and about 80% of patients with cirrhosis, it is not all patients can be radical resection. Therefore, in order to improve the quality of life and prolong the survival time as the goal of comprehensive treatment has become an important method for the treatment of liver cancer, and minimally invasive treatment is the main means of comprehensive treatment. At present, our department used in minimally invasive techniques in the treatment of clinical include radiofrequency ablation, ethanol injection therapy, interstitial permanent implantation, laparoscopic liver resection, laparoscopic combined with ultrasound guided radiofrequency ablation, percutaneous femoral artery puncture of hepatic artery embolization.

1 radiofrequency ablation of liver cancer under the guidance of B ultrasound or CT guided radiofrequency electrode needle inserted into the tumor, the use of the heat emitted by the electrode to produce tumor necrosis. The technology of small trauma, high safety, less complications and easy to tolerate, generally can be completed under local anesthesia. The lesions or can not tolerate surgery for the diameter of less than 5cm. In particular, I recently introduced from the United States, the "cold cycle RF treatment system", not only the effect of treatment than the ordinary radio frequency treatment instrument has been further improved, and the pain is smaller, fewer complications. At present, it is considered that the short-term curative effect is similar to that of surgical resection.

2 anhydrous alcohol injection therapy under the guidance of B ultrasound or CT, the needle will be injected into the body through the skin into the tumor, the injection of anhydrous alcohol, the use of anhydrous alcohol dehydration to kill tumor. The method has the advantages of simple operation, less pain, less complications and low cost, and can be used in combination with surgery or other therapies.

3 the permanent implantation of radioactive particles is a new method for the treatment of liver cancer". It is a radioactive isotope by surgery or minimally invasive way will a good package with certain specifications, the activity, the applicator or source applying catheter directly cast to hepatocellular carcinoma and internal radiation source according to tumor size and shape are arranged according to a certain rule, the tumor tissue in the near distance, and high radiation dose to the purpose of the treatment of disease.

4 laparoscopic hepatectomy is a new technique developed in recent years. The principle of tumor resection is basically the same as that of laparotomy, the difference is to avoid a large abdominal incision, instead of 4 to 5 key hole size. Mainly applicable to the tumor at the edge of liver or confined to a hepatic lobe or segment of the case. With the help of Cusa and TissueLink, we can improve the quality of operation, reduce intraoperative bleeding and expand the indications. Laparoscopic resection of liver cancer has the advantages of small trauma, little effect on liver function, and fast recovery. I Division in the field is located in the national advanced level.

5 laparoscopic and ultrasound guided radiofrequency ablation of liver cancer, which is a new type of surgery. Conventional radiofrequency ablation was performed in vitro. But if the cancer is located in the diaphragm, or surrounding organs such as gallbladder, colon, or in the ultrasonic probe and the blind, is incapable of action ablation procedure. At this time, such as the use of laparoscopic monitor and assist, above the special parts of the tumor can be safe and reliable for ablation. The use of this technology makes the indications of liver cancer radio frequency treatment significantly improved, and the safety and efficacy are greatly improved.

6 the blood supply of the normal liver tissue was obtained from the hepatic artery by percutaneous femoral artery puncture, and the hepatic artery was from the hepatic artery and the portal vein from 75%. The blood supply of liver cancer tissue is almost entirely from the hepatic artery. This therapy is to supply tumor embolization of hepatic artery, thereby blocking the blood supply of tumor tissue to a certain extent, slow growing tumors, some even can guide carcinogenic tissue necrosis and reduced for surgery or other radical treatment to create opportunities and conditions. Of course, this therapy also has some limitations, not all liver cancer are suitable for this treatment, depending on the specific circumstances. In particular, to be able to perform surgical resection, we should try to use surgical treatment, rather than blindly choose the treatment, so as not to delay the disease, affecting the efficacy and prognosis.

Four, non-invasive treatment of liver cancer

Ultrasound ablation for primary liver cancer is a new technique for noninvasive tumor therapy. Through my center hundreds of liver ultrasound ablation treatment has obvious curative effect. With the treatment of liver cancer center physician knowledgeable and rich clinical experience, the use of the most advanced HIFU focused ultrasound knife, ultrasound combined with minimally invasive vascular intervention, low price and practical treatment of liver cancer or intravascular injection of interventional therapy, immune therapy and other unique curative effect, slight trauma liver cancer treatment of new technology and new method, not only for early HCC, and of late, very large, intrahepatic vascular metastasis, various other methods of long treatment of liver cancer embolus, recurrence, residual, intrahepatic metastasis were treated, has made a very good therapeutic effect. Due to the unique characteristics of ultrasound ablation, such as no trauma, no radiation, immune enhancement, so that the patient's pain to a minimum, the highest efficacy.

Ultrasound ablation can treat the following liver cancer and has a unique advantage:

1 ultrasound ablation of small hepatocellular carcinoma is the largest diameter of less than 5 cm, and most of the early liver cancer. Ultrasound ablation in the treatment of small hepatocellular carcinoma has the characteristics of non-invasive, no surgery, no bleeding, less pain. The results showed that not only the treatment effect was good, but also the quality of life of the patients with small hepatocellular carcinoma treated by ultrasound ablation in our hospital. The long-term survival rate and survival time were significantly different from those of surgery and other trauma, but the recurrence and metastasis were significantly reduced.

After ablation, the tumor has disappeared

2 ultrasound ablation of liver cancer is the maximum tumor diameter greater than 5 cm, mostly in advanced liver cancer, not surgery, or difficult to accept. Other treatment, or treatment effect is not good. Large hepatocellular carcinoma by ultrasound ablation therapy (treatment center of the maximum diameter of the tumor for huge liver cancer 16 cm 3, figure 4 shows a huge left liver lobe liver cancer in ultrasound ablation ago) the survival time was prolonged, the probability of survival has also been greatly improved. Compared with the conventional interventional therapy, the efficacy of ultrasound ablation combined with interventional therapy for advanced hepatocellular carcinoma was increased by about 5~6 times

The results show that the giant liver cancer in the left lobe of the liver before ultrasound ablation treatment

3 ultrasound ablation in the treatment of cancer near important organs liver cancer when the tumor has this long or near to other important organs of the body, such as blood vessels, diaphragm, heart and lung, conventional surgery or other treatment, the treatment is difficult or unable to risk treatment. But because of the sea to help ® focused ultrasound is a noninvasive ultrasound using the ablation treatment, so the treatment of these tumors is more advantageous, such as ultrasound ablation in the treatment of large blood vessels near the liver, will not cause damage to large blood vessels and make the treatment of liver cancer. Clinically, ultrasound ablation can be safely complete treatment near large vessels (such as portal vein, inferior vena cava), diaphragm, heart, lung, stomach, pancreas and liver at the next door to complete the treatment of liver cancer, surgery, radiofrequency and other methods.

There are multiple lesions in the right lobe of the liver, and the residual remains of the superior vena cava in the superior vena cava

After the treatment of the same patient, the lesions of the lesions between the top of the diaphragm and the large vessels were completely necrotic, and the blood vessels and diaphragm were not damaged.

4 ultrasound ablation in interventional therapy of incomplete liver with hepatic artery and portal vein of two sets of blood supply nutrients, so the majority of liver cancer with hepatic artery and portal vein double blood supply, simple vascular intervention (TACE) is the use of vascular hepatic arterial lipiodol embolization and the lack of nutrition and death to tumor tumor the purpose of treatment of liver cancer, but double nutrition supply, making the simple vascular interventional treatment of liver cancer patients soon appeared easy residue, recurrence and metastasis. The use of ultrasound ablation can completely kill the residual cancer after intervention, greatly improve the therapeutic effect, without increasing the patient's pain.

5 radiofrequency ablation (RFA) for the treatment of liver cancer with incomplete radiofrequency ablation (RF) is the main treatment for liver cancer, which is less than 5 cm in diameter, the tumor shape is regular (spherical), and the blood supply is not abundant. Ultrasound ablation of liver cancer is not limited by the above, can completely kill the residual tumor after radio frequency, improve the therapeutic effect

6 ultrasound ablation for recurrent hepatocellular carcinoma after surgery

Liver trauma, prone to intrahepatic recurrence and metastasis after surgery, and postoperative bleeding, most patients itself liver function difference, surgical risk, ultrasound ablation can be noninvasive (no surgery) treatment of intrahepatic tumor recurrence and metastasis, prolong the survival time of patients, and reduce the recurrence transfer opportunities, and it is good to retain the normal liver tissue, but it has little effect on liver function, greatly reduces the risk of therapy, while patients with small trauma, less pain, anesthesia after the patient can eat and ambulation after the treatment of ultrasound ablation in treatment of hepatocellular carcinoma has very prominent advantages.

7 ultrasound ablation for the treatment of hepatocellular carcinoma with tumor thrombus in the liver

The liver is long vascular tumor thrombus, portal vein tumor thrombus, patients prone to gastrointestinal bleeding, liver failure, edema, and the disease is advanced, its treatment basically is a worldwide problem, at present there is no good way to treatment; conventional treatment by surgery remove the blood vessels within the tumor, but the tumor is easy to flow along the defect diffusion, tumor residual, surgical trauma, bleeding, the high risk and poor effect. I combined with ultrasound and ultrasound ablation center interventional catheterization of portal vein or the tumor drug injection in the treatment of portal vein tumor thrombus patients, some patients achieved good results after treatment not only tumor were killed, and complete or partial recanalization of portal vein, liver function recovered very well, with a higher quality of life and the survival time was prolonged

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