The experience of laparoscopic microwave coagulonecrotic therapy for hepatocellular carcinoma

Abstract

In recent years. We have various treatment options for hepatocellular carcinoma (HCC), including hepatic resection, transcatheter hepatic artery embolization (TAE), and percutaneous ethanol injection (PEI). However, some cases of HCCs are not suitable for these therapies due to their liver function and location of tumors. For some of these HCCs, we have developed laparoscopic microwave coagulonecrotic therapy (L -MCNT). The case of this report was 57-year-old man. The tumor was located in segment 8. The duration of MCNT was 30 minutes. The period of hospitalization after MCNT was 14days. Coagulated area involving tumor and surrounding tissue was not enhanced by postoperative dynamic CAT scan. L-MCNT is useful therapy for some HCCs.

The analysis of the usefulness of laparoscopic microwave coagulation therapy for hepatocellular carcinoma in patients with poor hepatic reserve by serial measurements of IL-6, cytokine antagonists, and C-reactive protein

“…Recently, the usefulness of microwave coagulation therapy (MCT) as a treatment option for hepatocellular carcinoma (HCC) with poor hepatic reserve has been reported, and clinical experiences of the laparoscopic approach in MCT (L-MCT) have also been reported [8,23,27,29]. Considering the benefit of the laparoscopic approach, L-MCT alleviates the surgical stress of MCT with the open method (O-MCT) because of its minimally invasive hepatic surgery.…”

“…A reduction in tissue trauma with the laparoscopic access when compared to the open approach is obviously expected and was demonstrated by randomized comparisons, and therefore, L-MCT was recommended as a treatment option for HCC with poorer hepatic reserve. Several series of patients with L-MCT of HCC have been published [8,23,27,29], although none of these previous series included an eveluation of tissue trauma. It would be interesting to know what selection criteria for L-MCT have been used for patients with unresectable HCC.…”

“…Recently, percutaneous microwave coagulation therapy (MCT) has become a widely practiced technique for small HCC with a maximum diameter of less than 2 cm [4,8,26]. MCT with the open method (O-MCT) has been introduced as a treatment option for HCC with poor hepatic reserve and can achieve long-term results equivalent to those obtained by wedge resections, but it is less invasive and technically easier [29]. Therefore, it can be an alternative option in place of limited resection for HCC with poor hepatic reserve.…”

“…Therefore, it can be an alternative option in place of limited resection for HCC with poor hepatic reserve. MCT using laparoscopic control (L-MCT) has also been introduced for unresectable HCC [8,23,27,29]. Recent reports have suggested that the laparoscopic approach is less invasive than open surgery in patients with colorectal cancer and urological disorders [5,17,25].…”

Easy and accurate targeting of deep-seated hepatic tumors under laparoscopy with a forward-viewing convex-array transducer

“…As a result, this method has not been widely used [1,8,12]. Even if laparoscopic treatment is performed under LUS guidance in other institutions, it is often applied only to HCCs, which are observed on the surface of the liver [17][18][19][20]. As described previously, one of the main reasons for this restriction is the difficulty in puncturing deep-seated tumors safely.…”