目的：比较超声引导下经皮射频消融与腹腔镜肝切除术治疗原发性小肝癌（直径≤3 cm）的疗效。方法：回顾性分析2012年1月—2015年6月35例行超声引导下经皮射频消融治疗的原发性小肝癌患者（消融组），以及同期30例行腹腔镜肝切除术治疗的原发性小肝癌患者（腔镜组）临床资料，比较两组患者的手术相关指标、术后复发率及生存情况。结果：与腔镜组比较，消融组手术时间（53.89 min vs. 128.57 min）、术中出血量（7.29 mL vs. 115.33 mL）、术后住院时间（1.86 d vs. 5.50 d）、住院费（1.73万元vs. 2.23万元）均明显减少（P<0.05）；术后肝功能指标、并发症发生率组间无统计学差异（均P>0.05）。消融组与腔镜组的手术根治率（97.1% vs. 100.0%）、3年复发率（51.4% vs. 40.0%）以及术后1、2、3年无瘤生存率（74.3% vs. 76.7%、62.9% vs. 66.7%、37.1% vs. 40.0%）与总生存率（85.7% vs. 86.7%、82.9% vs. 83.3%、77.1% vs. 80.0%）差异均无统计学意义（均P>0.05）。结论：射频消融与腹腔镜手术切除治疗原发性小肝癌的疗效相似。射频治疗具有创伤小、手术时间短、术后恢复快等优点，在小肝癌的治疗中有重要的临床价值。
Ultrasound guided percutaneous radiofrequency ablation versus laparoscopic hepatectomy for small primary liver cancer
Objective: To compare the efficacy of ultrasound guided percutaneous radiofrequency ablation (RFA) and laparoscopic hepatectomy in treatment of small primary cancer of the liver (diameter≤3 cm). Methods: The clinical data of 35 patients with small primary liver cancer undergoing ultrasound guided RFA (ablation group) from January 2012 to June 2015, and 30 patients undergoing laparoscopic hepatectomy (laparoscopic group) during the same period were retrospectively analyzed. The relevant surgical variables as well as the postoperative recurrence and survival rates between the two groups were compared. Results: In ablation group compared with laparoscopic group, the operative time (53.89 min vs. 128.57 min), intraoperative blood loss (7.29 mL vs. 115.33 mL), length of postoperative hospital stay (1.86 d vs. 5.50 d) and hospitalization cost (17 300 yuan vs. 22 300 yuan) were all significantly reduced (all P<0.05), while the changes in liver function parameters and incidence of postoperative complications had no statistical difference (all P>0.05). There was no significant difference in radical surgery rates (97.1% vs. 100.0%) and 3-year recurrence rates (51.4% vs. 40.0%) as well as 1-, 2- and 3-year disease-free survival rates (74.3% vs. 76.7%, 62.9% vs. 66.7%, 37.1% vs. 40.0%) and overall survival rates between ablation group and laparoscopic group (85.7% vs. 86.7%, 82.9% vs. 83.3%, 77.1% vs. 80.0%). Conclusion: RFA and laparoscopic hepatectomy have similar efficacy for small primary liver cancer. Therefore, RFA has the advantages of minimal invasiveness, shorter operative time and fast postperative recovery, so it has important clinical therapeutic value for small primary liver cancer.