Abstract: Objective To explore the efficacy and safety of CT-guided radiofrequency ablation （CT-FRA） in the treatment of patients with recurrent small liver cancer at the top of the diaphragm. Methods Sixty-nine patients with recurrent small liver cancer at the top of the diaphragm from February 2013 to April 2015 in our hospital were selected, of which 36 cases were treated with CT-FRA as the CT-FRA group, and 33 cases were treated with laparoscopic radiofrequency ablation （L-FRA） as the L-FRA group. The average ablation time, active tumor residual rate, complications, hospitalization time, hospitalization cost, average survival time, and the local progression rate and overall survival rate of the tumor at 1, 3 years were compared between the two groups. Results There was no significant difference in average ablation time and active tumor residual rate between the two groups （P>0.05）; the hospital stay in the CT-FRA group was shorter than that in the L-FRA group, and the hospitalization cost was lower than that in the L-FRA group （P<0.05）; there was no significant difference in the local tumor progression rate and overall survival rate between the two groups at 1 and 3 years （P>0.05）. Conclusion CT-FRA and L-FRA are effective treatments for recurrent small hepatocellular carcinoma at the top of the diaphragm, but CT-FRA is relatively economical, simple, and safe.

Key words: liver cancer, top of diaphragm, laparoscopic radiofrequency ablation, CT-guided radiofrequency ablation, recurrence

摘要： 目的 探究CT引导下射频消融术（CT-FRA）治疗膈顶部复发性小肝癌患者的疗效及安全性。方法 选取我院2013年2月~2015年4月膈顶部复发性小肝癌患者69例,其中36例采用CT-FRA治疗为CT-FRA组,33例采用腹腔镜下射频消融（L-FRA）治疗为L-FRA组。对比两组平均消融时间、活性肿瘤残留率、并发症、住院时间、住院费用、平均存活时间及1、3年肿瘤局部进展率、总体生存率。结果 两组平均消融时间、活性肿瘤残留率无显著差异（P>0.05）;CT-FRA组住院时间短于L-FRA组,住院费用低于L-FRA组（P<0.05）;两组1、3年肿瘤局部进展率、总体生存率无显著差异（P>0.05）。结论 CT-FRA、L-FRA均是治疗膈顶部复发性小肝癌的有效手段,但CT-FRA相对经济、简便、安全。

关键词: 腹腔镜下射频消融, 复发, 膈顶部, CT引导下射频消融术, 肝癌