Early Laparoscopic Radiofrequency Ablation for Spontaneous Rupture of Hepatocellular Carcinoma

Abstract

Early laparoscopic RF ablation therapy is an effective treatment measure for spontaneously ruptured HCC in selected patients, which presents an advantage of achieving simultaneous hemostasis, tumor elimination, and rinsing of peritoneal cavity to minimize the risk of peritoneal metastasis.

Management, outcomes, and prognostic factors of ruptured hepatocellular carcinoma: A systematic review

“…Searching the reference list (snowball procedure) retrieved two additional articles. In total, 67 studies were deemed eligible and therefore included in the systematic review …”

“…The mean age of the study population was 55.6 years (SD = 6.64) with most patients being male (77.9%). A large portion of the cohort population consisted of patients from Asia, as 22 studies (33%) were from China, 17 (25%) from Japan, 10 (15%) from Taiwan, 5 (7.5%) from Korea, 2 (3%) from Thailand, and 1 (1.5%) each from Singapore and Malaysia . In contrast, studies about rHCC were less common from Western centers with only 2 reports (3%) from the Netherlands and Italy, and 1 (1.5%) each from Canada, France, United Kingdom, USA, and Nigeria .…”

“…The long‐term outcomes among all patients in the cohort were summarized (Figure ) . Long‐term cause of death was related to cancer recurrence and metastasis (17.2% of overall cohort).…”

Treatment of spontaneously ruptured hepatocellular carcinoma: use of laparoscopic microwave ablation and washout

“…21 As locoregional ablative therapy use became more widespread as a definitive treatment for HCC, open radiofrequency ablation (RFA) to treat rHCC emerged as a means to simultaneously achieve hemostasis and ablate tumor. 30,31 Used in conjunction with laparotomy only if ongoing blood loss after conservative treatment or TACE, one series demonstrated effective hemostasis and improved overall survival with RFA. 32 Similarly, MWA has been successfully employed to control intra-operative hepatic hemorrhage, although routine use for concomitant hemorrhage and tumor treatment has not (to current knowledge) been reported outside of this institution.…”

Early experience with laparoscopic liver resection for spontaneously ruptured hepatocellular carcinoma

“…demonstrated that even when peritoneal recurrence does occur following resection of a srHCC, laparoscopic extirpation of the peritoneal metastatic lesions can be effectively performed even if the index surgery was performed open. [ 31 ] There are also reports of successful local ablation of srHCC in the emergency setting via laparoscopic-guided RFA[ 32 ] and microwave ablation. [ 33 ]…”