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肝恶性肿瘤开放与腹腔镜消融术——一项随机临床试验方案

英文原题:Open versus laparoscopic ablation of liver malignancies - a protocol for a randomised clinical trial.

查看英文原题

Open versus laparoscopic ablation of liver malignancies - a protocol for a randomised clinical trial.

PubMed 2026/01/14(内容时间) Dan Med J Q3 · IF 1.1(JCR 2025)

研究概要

本试验将首次对不适合经皮消融的肝肿瘤进行腹腔镜消融与开腹消融的随机对照比较。我们假设腹腔镜消融可以降低术后并发症发生率,同时保持相当的疗效,有可能为特定患者确立新的治疗标准。

研究思路结论见上方概要

基于热消融已成为原发性和转移性肝癌手术切除的一种创伤更小的替代方案。然而,当经皮途径不可行时,通常会在开放手术中进行消融。开放手术可能伴随并发症风险增加,尤其是在合并症或肝硬化患者中。腹腔镜消融可能在提供相似疗效的同时降低发病率;然而,即便如此,尚未开展随机研究。

80名成人患者将在一家高容量肝胆中心按1:1随机分配至开腹消融或腹腔镜消融。符合条件的参与者至少有一个适合消融但不适合经皮途径的肝脏肿瘤。主要终点是术后30天内并发症(Clavien-Dindo ≥ 2)的发生率。次要结局包括消融成功、住院时间、术后疼痛、生活质量和恢复以及90天死亡率。

展开英文摘要原文

INTRODUCTION: Heat-based ablation has emerged as a less invasive alternative to surgical resection for primary and metastatic liver cancer. However, when a percutaneous approach is not feasible, ablation during open surgery is often performed. Open surgery may be accompanied by an increased risk of complications, especially in patients with comorbidities or liver cirrhosis. Laparoscopic ablation may reduce morbidity while offering a similar efficacy; however, even so, no randomised studies have been conducted. METHODS: Eighty adult patients at a high-volume hepatobiliary centre will be randomised 1:1 to either open or laparoscopic ablation. Eligible participants have at least one liver tumour amenable to ablation but unsuitable for a percutaneous approach. The primary endpoint is the rate of complications (Clavien-Dindo ≥ 2) within 30 days after surgery. Secondary outcomes include ablation success, length of stay, post-operative pain, quality of life and recovery and 90-day mortality. CONCLUSIONS: This trial will provide the first randomised comparison of laparoscopic and open ablation for liver tumours that are not amenable to percutaneous ablation. We hypothesise that laparoscopic ablation can reduce post-operative complication rates while maintaining comparable efficacy, potentially establishing a new standard of care for selected patients. FUNDING: LAK and HCP have received unrestricted research grants from the Danish Cancer Society, Independent Research Fund Denmark, The Danish Health Authority and the Research Council of Copenhagen University Hospital - Rigshospitalet. CLINICALTRIALS ID: NCT06304766.

论文信息

作者
Knøfler LA、Klubien J、Larsen PN、Kiim KS、Fukumori D、Tschuor C、Nielsen SD、Pommergaard HC
单位
Department of Digestive Diseases, Transplantation and General Surgery, Copenhagen University Hospital - Rigshospitalet.Denmark
文献类型
随机对照试验 · 对照研究
期刊
Danish medical journal2026 Jan 14
原文标识
PubMed 41736646 · DOI 10.61409/A04250305