title: A combination therapy of ethanol injection and radiofrequency ablation under general anesthesia for the treatment of hepatocellular carcinoma.
abstract: OBJECTIVE
  To summarize the effects of laparoscopic ethanol injection and radiofrequency ablation (L-EI-RFA), thoracoscopic (T-EI-RFA) and open-surgery assisted EI-RFA (O-EI-RFA) under general anesthesia for the treatment of hepatocellular carcinoma (HCC).
  
  
  METHODS
  Time-lag performance of RFA after ethanol injection (Time-lag PEI-RFA) was performed in all cases. The volume of coagulated necrosis and the applied energy for total and per unit volume coagulated necrosis were examined in the groups treated under general (group G) or local anesthesia (group L).
  
  
  RESULTS
  The results showed that the total applied energy and the applied energy per unit volume of whole and marginal, coagulated necrosis were significantly larger in group G than those in the group L, resulting in a larger volume of coagulated necrosis in the group G. The rate of local tumor recurrence within one year was extremely low in group G.
  
  
  CONCLUSIONS
  These results suggest that EI-RFA, under general anesthesia, may be effective for the treatment of HCC because a larger quantity of ethanol and energy could be applied during treatment under painfree condition for the patients.
authors.affiliation: Department of Gastroenterology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. kuroko@med.kagawa-u.ac.jp
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kurokohchi
authors.forename: Seishiro
authors.initials: S
authors.lastname: Watanabe
authors.forename: Hirohito
authors.initials: H
authors.lastname: Yoneyama
authors.forename: Akihiro
authors.initials: A
authors.lastname: Deguchi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Himoto
authors.forename: Hisaaki
authors.initials: H
authors.lastname: Miyoshi
authors.forename: Hamdy-Saad
authors.initials: HS
authors.lastname: Mohammad
authors.forename: Akira
authors.initials: A
authors.lastname: Kitanaka
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Taminato
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kuriyama
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000532:radiotherapy*; D017115:Catheter Ablation; D003131:Combined Modality Therapy / Q000379:methods; D000431:Ethanol / Q000494:pharmacology*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000431:Ethanol