title: [Adjuvant surgery to enhance therapeutic effects of chemo-embolization in advanced hepatocellular carcinoma].
abstract: Different kinds of adjuvant surgery were carried out in three patients with advanced hepatocellular carcinoma (HCC) to enhance the therapeutic effects of chemo-embolization (TAE). The first patient, who had multiple foci localized in the right lobe, underwent ligation of the right portal vein in order to eliminate the small intrahepatic spreads and to protect against transportal metastasis to the left lobe. Afterward, TAEs were repeated a total of 5 times. The patient is still alive 24 months after the surgery with partial remission of the lesions. The second patient with severe cirrhosis had received TAE twice. Since one of the tumors, which existed in the hepatic hilus, did not respond to TAE, only the non-respondent tumor was removed surgically. This patient remains alive 28 months after the surgery with complete remission of the lesions. In the third patient, repeated TAEs resulted in collateral feeding arteries. Permanent decollateralization using silicone rubber sheeting was carried out following ligation of collaterals. Thus adjuvant surgery to enhance the therapeutic effects of TAE may be a significant palliative treatment for HCC.
authors.affiliation: Dept. of Surgery, Center for Adult Diseases, Osaka.
authors.forename: Y
authors.initials: Y
authors.lastname: Sasaki
authors.forename: S
authors.initials: S
authors.lastname: Imaoka
authors.forename: T
authors.initials: T
authors.lastname: Shibata
authors.forename: H
authors.initials: H
authors.lastname: Wada
authors.forename: H
authors.initials: H
authors.lastname: Nagano
authors.forename: M
authors.initials: M
authors.lastname: Kameyama
authors.forename: H
authors.initials: H
authors.lastname: Ohigashi
authors.forename: M
authors.initials: M
authors.lastname: Hiratsuka
authors.forename: O
authors.initials: O
authors.lastname: Ishikawa
authors.forename: T
authors.initials: T
authors.lastname: Kabuto
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000601:surgery / Q000628:therapy*; D002945:Cisplatin / Q000627:therapeutic use; D003097:Collateral Circulation; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use; D008026:Ligation; D008113:Liver Neoplasms / Q000098:blood supply / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery; D019736:Prostheses and Implants; D012074:Remission Induction; D012826:Silicone Elastomers
chemical_list: D012826:Silicone Elastomers; D007459:Iodized Oil; D002945:Cisplatin