[Endoscopic local ablation therapy (ELAT) for hepatocellular carcinoma--inventive approaches to achieve radical treatment and to expand the indication of ELAT].
We introduce some inventive approaches in endoscopic local ablation therapy (ELAT) for patients with hepatocellular carcinoma (HCC). ELAT is applied in cases of HCC when the tumor is smaller than 3 cm on the surface of the liver (smaller than 4 cm with extrahepatic growth), and tumor numbers < or = 3. Appropriate use of the laparoscopic, thoracoscopic and hand-assisted approaches, suitable preceding embolizations with the angiographic technique, a combination of ablation therapy, and the use of CO2-angio US, DIMON puncture system and cluster needle are important. If necessary, additional surgeries such as endoscopic hepatectomy, laparoscopic cholecystectomy or laparoscopic devascularization must be performed together. As a result, it will be possible to expand the indication of ELAT safely and radically.
Beppu
Toru
T
Dept. of Gastroenterological Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University.
Doi
Koichi
K
Ishiko
Takatoshi
T
Maeda
Takeharu
T
Ikeda
Osamu
O
Matsuo
Akinobu
A
Ida
Satoshi
S
Imamura
Yutaka
Y
Egami
Hiroshi
H
Ogawa
Michio
M
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004564:Electrocoagulation; D004724:Endoscopy; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008872:Microwaves / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed