Percutaneous and laparoscopic approaches of radiofrequency ablation treatment for liver cancer.
OBJECTIVE
Radiofrequency ablation (RFA) and microwave coagulation therapy (MCT) have been gaining acceptance as a standard method in the management strategy of liver cancer, for reasons of minimally invasive techniques and effective results. We present our experience of RFA and MCT in patients with liver cancer, and analyze retrospectively the advantages and disadvantages of both of the percutaneous and laparoscopic approaches.


METHODS
Thirty-two consecutive patients (23 men and 9 women) with 19 hepatocellular carcinomas (HCC), 12 metastatic liver cancers, and recurrent cholangiocellular carcinoma (CCC), were enrolled in this study. Out of these 32 patients, as a prior laparotomy, 19 underwent hepatectomy, colectomy, gastrectomy or cholecystectomy, and 15 were treated with the laparoscopic approach, 17 treated with the percutaneous approach, and 2 treated with the combined approach of those two. All of these procedures were carried out under general anesthesia with ultrasound guidance. Seven and 30 days after these procedures, an assessment helical computed tomography was done.


RESULTS
No sign of the residual tissues was noted in all patients except only one case.


CONCLUSIONS
The percutaneous approach was thought to be a more practical and less invasive method regardless previous laparotomy. For the laparoscopic approach, tumors located at the hepatic surface or margin were preferable candidates.
Yokoyama
Tadashi
T
Department of Surgery, Nippon Medical School, Tama-Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan.
Egami
K
K
Miyamoto
M
M
Watanabe
H
H
Hasegawa
H
H
Iida
S
S
Suzuki
S
S
Nakamura
Y
Y
Okawa
K
K
Hagiwara
N
N
Takashima
Y
Y
Yoshioka
M
M
Tajiri
T
T
Onda
M
M
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D018281:Cholangiocarcinoma / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome