Microwave coagulation therapy for a liver tumor involving the root of the left hepatic vein of the residual liver after extended right hepatectomy.
A 54-year-old man had received low anterior resection for rectal carcinoma and extended right hepatectomy for a metastatic liver tumor. One year later, imaging studies disclosed a metastatic liver tumor in segment 2 of the liver. The residual left hepatic vein was completely invaded by the tumor from the root of the hepatic vein to the confluence of several branches by intraoperative ultrasonography. To resect partial liver with the involved hepatic vein was deemed impossible. Microwave coagulation therapy was performed on the tumor and the involved hepatic vein, as we had established the safety of microwave irradiation to the main hepatic vein without interference of the hepatic venous flow in an experimental study. The patient remains well 40 months after the surgery without recurrent signs. The hepatic venous flow of the irradiated hepatic vein is maintained well according to serial examination of Doppler ultrasonography.
Midorikawa
Takemasa
T
Department of Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
Kikuchi
Hiroaki
H
Ishibashi
Kazuyoshi
K
Saito
Mitsuo
M
Hatakeyama
Toshiyuki
T
Kadokura
Shigeki
S
Matsumoto
Tadashi
T
Miyakawa
Kiyoshi
K
Maezawa
Kouji
K
Uemichi
Osamu
O
Izuno
Hisayuki
H
Aita
Kunitoshi
K
Nemoto
Hiroshi
H
Nagasaki
Hideaki
H
Yagi
Hidefumi
H
D002277:Carcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D006498:Hepatectomy; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000528:radiation effects*; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D014463:Ultrasonography