title: Hybrid ablation using percutaneous and endoscopic approach for multi-nodular hepatocellular carcinomas.
abstract: OBJECTIVE
  To investigate the efficacy and the safety of a hybrid ablation combining a percutaneous and endoscopic approach for multi-nodular hepatocellular carcinomas.
  
  
  METHODS
  Hybrid ablation consists of a percutaneous approach for deep-sited tumors and an endoscopic approach for superficial ones. Between January 1991 and December 2007, forty eight patients with 139 nodules were treated with hybrid ablation. The perioperative clinical data and prognosis of the hybrid approach group were compared with 15 patients with superficial and deep-sited multinodular HCCs treated by the pure endoscopic ablation.
  
  
  RESULTS
  With regard to the deep-site of the liver tumors, the complete disappearance of tumor enhancement was observed in 76 of 77 tumors (98.7%) in the hybrid ablation group and 15 of 18 tumors (83.3%) in the pure endoscopic ablation group (p=0.02). The mean operation time (236.5min), the mean amount of intraoperative bleeding (20.3g), the median days of postoperative hospital stay (14 days), major complication rates (10.4%) and the 5-year overall survival (42%) in the hybrid ablation group were similar to the pure endoscopic group.
  
  
  CONCLUSIONS
  Hybrid ablation is a clinically useful treatment for multi-nodular hepatocellular carcinomas located in both the superficial and deep-site of the liver.
authors.affiliation: Department of Gastroenterology Surgery, Kumamoto University, Kumamoto University, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Takao
authors.initials: T
authors.lastname: Mizumoto
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Ryu
authors.initials: R
authors.lastname: Otao
authors.forename: Hasita
authors.initials: H
authors.lastname: Horlad
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016009:Chi-Square Distribution; D004724:Endoscopy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome