title: Simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy for the treatment of hepatocellular carcinoma with cirrhotic hypersplenism.
abstract: OBJECTIVE
  To establish the efficacy and safety of simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy (Lap-Sp) for the treatment of hepatocellular carcinoma (HCC) with cirrhotic hypersplenism.
  
  
  METHODS
  Seventeen patients with HCC and cirrhotic hypersplenism underwent simultaneous MCN and Lap-Sp at our institution between January, 2010 and July, 2015. Eight and nine patients had Child-Pugh class A and B liver cirrhosis, respectively. The median number of tumors ablated was 1 (range 1-7) and the median largest dimension of the resected lesions was 1.7 cm (range 1.1-3.6 cm). We analyzed postoperative complications and long-term outcomes retrospectively.
  
  
  RESULTS
  The median operating time was 283 min (range 197-418 min) and the median blood loss was 125 mL (range 5-1312 mL). Postoperative morbidity and mortality rates were 29 and 0 %, respectively. The median follow-up time after surgery was 22.5 months (range 4.3-70.9 months). The 1-, 3-, and 5-year disease-free survival rates were 68.8, 10.7, and 10.7 %, respectively, and the 1-, 3-, and 5-year overall survival rates were 88.2, 75.6, and 63.0 %, respectively.
  
  
  CONCLUSIONS
  The findings of this study suggest that simultaneous MCN and Lap-Sp is safe and effective for treating HCC with cirrhotic hypersplenism.
authors: Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan. tmk.ryu@kyumed.jp.
authors: Tomoki
authors: T
authors: Ryu
authors: Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan.
authors: Yuko
authors: Y
authors: Takami
authors: Department of Gastroenterological Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
authors: Norifumi
authors: N
authors: Tsutsumi
authors: Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan.
authors: Masaki
authors: M
authors: Tateishi
authors: Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan.
authors: Kazuhiro
authors: K
authors: Mikagi
authors: Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan.
authors: Yoshiyuki
authors: Y
authors: Wada
authors: Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan.
authors: Hideki
authors: H
authors: Saitsu
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D006971:Hypersplenism / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Hepatocellular carcinoma; Hypersplenism; Laparoscopic splenectomy; Microwave ablation; Microwave coagulo-necrotic therapy