title: Thoracoscopic local ablation with diaphragmatic incision method for liver surface tumor in the hepatic dome.
abstract: OBJECTIVE
  To assess the feasibility and effectiveness of thoracoscopic local ablation therapy with diaphragmatic incision method.
  
  
  BACKGROUND
  Liver tumor in the hepatic dome limits the approach method of ablation. These lesions are accessible through a transdiaphragm, and incision of diaphragm by thoracoscopic surgery might be a valuable option.
  
  
  METHODS
  Between July 1995 and December 2011, 59 patients with a tumor in the hepatic dome were indicated for thoracoscopic local ablation therapy. The diaphragm above tumor was incised and tumors were ablated thoracoscopically.
  
  
  RESULTS
  The mean operating time and blood loss was 222 minutes and 33.8 g, respectively. There was no postoperative mortality, and 7 patients with complications recovered successfully. The 5-year overall survival (OS) rate for hepatocellular carcinoma was 51.0%. Local recurrence was suspected in 2 cases.
  
  
  CONCLUSIONS
  Thoracoscopic ablation by incision of the diaphragm represents a feasible approach for the tumor in the hepatic dome with acceptable long-term outcomes.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Faculty of Life Science, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.forename: Katunori
authors.initials: K
authors.lastname: Imai
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Hiromitu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nitta
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D003964:Diaphragm / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D061646:Operative Time; D013906:Thoracoscopy / Q000379:methods*