title: Thoracoscopic thermal ablation therapy for hepatocellular carcinoma located beneath the diaphragm.
abstract: OBJECTIVE
  Percutaneous interstitial thermal ablation therapy effectively treats hepatocellular carcinoma (HCC) that can be visualized on percutaneous ultrasonography. However, when the tumor is located just under the top of the diaphragm, visualization can be difficult with conventional ultrasonographic examination. There are also problems concerning complete tumor ablation. We performed thoracoscopic thermal ablation therapy for HCC located just beneath the diaphragm in nine patients with advanced liver cirrhosis.
  
  
  METHODS
  Eight patients underwent thoracoscopic microwave coagulation therapy, and one patient underwent thoracoscopic radiofrequency ablation therapy.
  
  
  RESULTS
  Despite the poor hepatic reserve, postoperative recovery after thoracoscopic thermal ablation therapy was rapid in all patients, without deterioration of hepatic function.
  
  
  CONCLUSIONS
  This preliminary study suggests that the new technique of thoracoscopic thermal ablation therapy is a less invasive optional therapy for HCC located in segments VII or VIII in cirrhotic patients.
authors.affiliation: Dept. of Gastroenterology, Tokyo University Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan. takduck-tky@umin.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Ishikawa
authors.forename: T
authors.initials: T
authors.lastname: Kohno
authors.forename: T
authors.initials: T
authors.lastname: Shibayama
authors.forename: Y
authors.initials: Y
authors.lastname: Fukushima
authors.forename: S
authors.initials: S
authors.lastname: Obi
authors.forename: T
authors.initials: T
authors.lastname: Teratani
authors.forename: S
authors.initials: S
authors.lastname: Shiina
authors.forename: Y
authors.initials: Y
authors.lastname: Shiratori
authors.forename: M
authors.initials: M
authors.lastname: Omata
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods; D003964:Diaphragm; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use; D008875:Middle Aged; D013906:Thoracoscopy; D016896:Treatment Outcome