Laparoscopic and thoracoscopic approaches for the treatment of hepatocellular carcinoma.
BACKGROUND
Laparoscopic/thoracoscopic intervention has been recently developed for hepatocellular carcinoma (HCC). However, no precise evaluation regarding this type of surgery has been performed.


METHODS
A total of 33 laparoscopic and thoracoscopic treatments were performed on HCC patients, laparoscopic or thoracoscopic liver resection (LTR) in 15 patients and laparoscopic or thoracoscopic thermal ablation (LTA) in 18 patients.


RESULTS
Postoperative hospital stay was 12.7 days after resection and 14.8 days after ablation. The 1- and 3- year actuarial survival rate were 100% and 80%, respectively, after LTR and 95% and 75%, respectively, after LTA. The 1- and 3- year disease-free survival rates were 75% and 40%, respectively, after LTR, and 60% and 28%, respectively, after LTA.


CONCLUSIONS
LTR has the advantages of the curability of open surgery and less invasiveness of laparoscopic surgery. LTA is useful for tumors that cannot be percutaneously detected by ultrasound. Laparoscopic/thoracoscopic intervention is therefore considered an alternative means of treatment for selected HCC patients.
Teramoto
Kenichi
K
Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-Ku, Tokyo, Japan 1138519. teraken.srg1@tmd.ac.jp
Kawamura
Tohru
T
Takamatsu
Susumu
S
Nakamura
Noriaki
N
Kudo
Atsushi
A
Noguchi
Norio
N
Irie
Takumi
T
Arii
Shigeki
S
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome