Laparoscopic radiofrequency ablation and hepatic artery infusion pump placement in the evolving treatment of colorectal hepatic metastases

Abstract

LRFA and/or LHAIP placement are safe and feasible treatment options for the treatment of colorectal hepatic metastases. The choice of treatment for patients should be based primarily on tumor characteristics. Long-term studies, which will elucidate the role of these evolving treatments, are now under way.

Laparoscopic Placement of Hepatic Artery Infusion Pumps: Technical Considerations and Early Results

“…It has also been suggested that pump placement at the time of resection and/or RFA of liver metastases to facilitate adjuvant therapy may offer better hepatic tumor control and reduce the rate of hepatic recurrence. 11,17 Hepatic arterial pump chemotherapy normally requires a full laparotomy for placement of catheter and pump. Even though the reported morbidity associated with the open procedure is small, it is still considered less than desirable for this patient group.…”

“…Since then, there have been limited reports regarding this novel procedure, which include our own results. [10][11][12]19 The success of HAI therapy is dependent on careful patient selection and meticulous surgical technique. It is critically important that the distribution of chemotherapy reaches the entire liver without misperfusion.…”

“…The details of laparoscopic placement of HAIP have been described previously. 10,11 Under general endotracheal anesthesia, all patients were placed in supine position. The surgeon stood to the patient's left and the assistant stood between the legs or to the patient's right.…”

Robotic-assisted placement of a hepatic artery infusion catheter for regional chemotherapy

“…A minimally invasive pump placement using conventional laparoscopic techniques has been described in the literature [9][10][11][12]. Franklin et al reported a series of 20 laparoscopic pump placements during concurrent major laparoscopic procedures with no conversions and no intraoperative complications [10].…”

Radiofrequency Ablation of Hepatic Malignancies: The Surgeon's Perspective

“…Indeed, hepatic colorectal metastases are the leading cause of cancerrelated morbidity and mortality in Western society. 1 However, a minority (10-20%) of patients with hepatic colorectal metastases will be candidates for liver resection (reviewed Cheng et al, 4 and Kitamoto et al 5 ). In many of these patients, the liver is the only site of metastasis.…”