Laparoscopic-assisted microwave ablation in treatment of small hepatocellular carcinoma: safety and efficacy in comparison with laparoscopic hepatectomy.

Laparoscopic-assisted microwave ablation (LAMWA), as one of the locoregional therapies, has been employed to treat hepatocellular carcinoma (HCC). This study aims to compare the efficacy and safety of LAMWA and laparoscopic hepatectomy in the treatment of small HCC.This study included 140 patients who met the inclusion criteria. Among them, 68 patients received LAMWA and 72 patients underwent laparoscopic hepatectomy. The perioperative condition, liver function recovery, the alpha fetoprotein (AFP) level, morbidities, hospitalization time, overall survival (OS), disease-free survival (DFS) and recurrence rate between the two groups were compared. The rate of complete elimination of tumor tissue was 100% and the AFP level was returned to normal within 3 months after surgery in both groups (P > 0.05). The mean alanine transaminase (ALT) and aspartate transaminase (AST) peak in the LAMWA group was lower than that in the laparoscopic hepatectomy group (259.51 ± 188.75 VS 388.9 ± 173.65, P = 0.000) and (267.34 ± 190.65 VS 393.1 ± 185.67, P = 0.000), respectively. The mean operation time in the LAMWA group was shorter than that in the laparoscopic hepatectomy group (89 ± 31 min VS 259 ± 48 min, P = 0.000). The blood loss in the LAMWA group was less than that in the laparoscopic hepatectomy group (58.4 ± 64.0 ml VS 213.0 ± 108.2 ml, P = 0.000). Compared with the laparoscopic hepatectomy group, patients in the LAMWA group had lower mean hospital stay (4.8 ± 1.2d VS 11.5 ± 2.9d, P = 0.000). The morbidities of the LAMWA group and the hepatectomy group were 14.7%(10/68) and 34.7%(25/72), respectively (P = 0.006). The one-, three-, and five-year OS rates were 88.2%, 69.9%, 45.6% for the LAMWA group and 86.1%, 72.9%, 51.4% for the laparoscopic hepatectomy group (P = 0.693). The corresponding DFS rates for the two groups were 76.3%, 48.1%, 27.9% and 73.2%, 56.7%, 32.0% (P = 0.958). Laparoscopic-assisted microwave ablation is a safe and effective therapeutic option for selected small HCC.

[Effects of Algal Blooms and Their Degradation on the Sediment-water Micro-interface].

Effects of algal blooms and their degradation on the sediment-water micro-interface under conditions of disturbance and darkness were investigated. The concentration of chlorophyll a in water was determined via the acetone method, profiles of oxygen near the interface were measured using a microelectrode, and profiles of nutrients and metals in sediments were measured at the millimeter level. The results showed that algal bloom degradation at the sediment-water micro-interface decreased the concentration of oxygen and affected nutrient and metal profiles, at depths over approximately 3 mm. Disturbance played an important role in algal bloom degradation and early diagenesis processes of nutrients, such as C and P, and metals, such as Fe, Ca, Mg, Al, and K. Darkness sped up algal bloom degradation and reduced the influence of disturbance. Under control conditions of no disturbance nor algae, and supplied with enough light, a layer of benthic algae appeared at the sediment surface, whose photosynthesis produced oxygen and greatly changed the microenvironment. This brought about significant differences in the concentrations of nearly all nutrients and metals in the surficial sediment compared with those of other treatments. Correlation analyses showed that the vertical variability of sediment P concentration was most strongly related to sediment Mn, followed by sediment C. The results of this high-resolution research showed that algal bloom degradation had an effect on the sediment-water micro-interface at the millimeter level.