Abstract：Objective To evaluate the strategies of percutaneous microwave ablation in the treatment of large hepatocellular carcinoma, and the principle of needle arrangement, the treatment effect and its complications. Methods Ninely-nine patients with hepatocellular carcinoma (134 nodules) underwent microwave ablation treatment with guided by ultrasound . According to the size and the shape of lesions and their surrounding anatomic structures, different therapeutic plans and different needle distribution modes were applied,leading to relevant curative effects which were evaluated. Results Complete ablation rates were 97.78%(44/45),94.44%(34/36), and 73.68%(14/19) in those nodules of 4.1-5.0 cm, 5.1-6.0 cm, and >6 cm respectively,with a total ablation rate of 94.03%(124/134). Ultrasound-guided microwave ablation arangements were successful in 46 lessions neibouring to vital anatomic strutures,and the complete tumor ablation rate was 86.05% (37/43). Total complication rate after microwave ablation was 21.21 (21/99)%, and after symptomatic treatment, all complications disappeared naturally. Local recurrence rate was 18.66% (25/134), and distant recurrence rate was 15.15% (15/99). 1, 2, 3, 5 year accumulative total survival rates were 89.90% (89/99),71.83%(51/71), 53.06%(26/49),28.57%(4/14), respectirely. Conclusion The conbined plan of carpet-mode ablation,fire wall ablation strategy and extending ablation range is safe, effective, and feasible, in treatment of large HCC neibouring to vital anatiomic structures.
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2013, Vol. 24 
