【Abstract】ObjectiveTo evaluate the efficacy of whole body hyperthermia (WBH) in the treatment of advanced hepatic carcinoma and its effect on liver function. MethodsFrom 2001 to 2004, 39 cases of advanced hepatic carcinoma were treated with WBH. The effect of WBH on liver function was assessed by liver function test before and after treatment. Results①The effective rate of WBH was 61.5%（24／39） in the treatment of advanced hepatic carcinoma with declined AFP in 60.0%（9/15） of patient and 100% of patients had pain relieve. The survival rates of 6 months, 1 year and 2 years were 76.9%（30/39）, 59.0%（23/39） and 12.8%（5/39）, respectively. ②Alanine aminotransferase (ALT) elevated obviously in 1-3 d after treatment (Plt;0.05), and then approached to its baseline in 7 d. Aspartate aminotransferase (AST) increased significantly 1 d after treatment (Plt;0.05),and then back to its baseline in 3-7 d. Albumin (ALB) appeared dropped 1 d after treatment (Plt;0.05), and restored normally in 3 d. The levels of total bilirubin (TBIL) and gamma glutamyl transpeptidase (GGT) had no evident significant change with the WBH treatment in abnormal liver function group, but TBIL increased 1-3 d after treatment in normal liver function group (Plt;0.05). ConclusionIn the treatment of advanced hepatic carcinoma, WBH can improve the patients’ life quality and prolong their life expectancy. Meanwhile, it could also result in reversible impairment of liver function.
ObjectiveTo explore the feasibility of laparoscopic hepatectomy of malignant liver tumors under the day surgery management model based on the concept of enhanced recovery after surgery (ERAS). MethodsThree patients who underwent same-day laparoscopic resection of malignant liver tumors in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Guangxi Medical University from June to November 2022 were retrospectively collected. The clinical application effects of this model were comprehensively evaluated. ResultsAll 3 patients (cases 1–3) successfully completed complete laparoscopic anatomical partial liver resection, with operation times of 155, 183, and 201 min, respectively, and intraoperative blood loss of all <100 mL (20, 100, and 50 mL, respectively). Postoperative pathology confirmed that cases 1 and 2 were hepatocellular carcinoma, and case 3 was colorectal adenocarcinoma with liver metastasis, and the resection margins all met the R0 standard. All patients resumed oral feeding 6 h after surgery and were able to get out of bed within 8 h after surgery. All 3 patients were discharged within 24 h after surgery. The hospitalization cost of the three patients was (22 602.0±3 400.0) yuan. All patients were followed up for more than 24 months and maintained a tumor-free survival state, without tumor recurrence and metastasis. ConclusionThe results of this limited cases suggest that same-day laparoscopic liver resection is initially feasible and safe for strictly selected patients with liver malignancies combined with a standardized ERAS management pathway.