TY - JOUR
T1 - Laparoscopic radiofrequency ablation combined with laparoscopic liver resection for more than one HCC on cirrhosis
AU - Belli, Giulio
AU - D'Agostino, Alberto
AU - Fantini, Corrado
AU - Cioffi, Luigi
AU - Belli, Andrea
AU - Russolillo, Nadia
AU - Langella, Serena
PY - 2007/8
Y1 - 2007/8
N2 - The management of patients affected by more than one hepatocellular carcinoma (HCC) is still controversial but nowadays a multimodal approach to this pathology seems to be the most effective and versatile therapeutic option. When orthotopic liver transplantation is not indicated, survival-time and quality of life improvement is the goal for patients who will have a long metabolic and oncologic disease history. Combined use of minimally invasive nonsurgical treatments [percutaneous ethanol injection, radiofrequency ablation, transcutaneous arterial chemioembolization (TACE)] allows to offer to the patients the advantages of each therapeutic procedure reducing their individual side effects and complications. We consider laparoscopy as a minimally invasive procedure, which can offer the benefits of surgical treatment, by tumor removing, but with an improved postoperative course. If recurrence risk factors are present, the costs/benefits rapport can be decreased by the laparoscopic approach which offers, in addition to a radical resection, a decreased postoperative pain, reduced trauma to the abdominal wall, smaller incisions, reduced peritoneal adhesions and, in selected cases, an earlier beginning of chemiotherapy. We report the case of a patient affected by more than one HCC with a bigger lesion of 50 mm protruding from hepatic segment III, one subcapsular lesion located at segment V, and one deep lesion located at segment VII-VIII. The patient was submitted to a double laparoscopic liver resection in association with laparoscopic radiofrequency ablation. Five months later, the patient presented an early recurrence of malignancy that was treated by TACE. At 8 months from the treatment, the patient presented another multifocal recurrence and was submitted to another TACE. At 2 years from the laparoscopic procedure, the patient is in apparent good conditions with an acceptable quality of life. We think that laparoscopic resection could gain a considerable place in the multimodal treatment of cirrhotic liver with more than one HCC because, by tumor removing, it offers the benefits of surgical treatment with a lower complications rate.
AB - The management of patients affected by more than one hepatocellular carcinoma (HCC) is still controversial but nowadays a multimodal approach to this pathology seems to be the most effective and versatile therapeutic option. When orthotopic liver transplantation is not indicated, survival-time and quality of life improvement is the goal for patients who will have a long metabolic and oncologic disease history. Combined use of minimally invasive nonsurgical treatments [percutaneous ethanol injection, radiofrequency ablation, transcutaneous arterial chemioembolization (TACE)] allows to offer to the patients the advantages of each therapeutic procedure reducing their individual side effects and complications. We consider laparoscopy as a minimally invasive procedure, which can offer the benefits of surgical treatment, by tumor removing, but with an improved postoperative course. If recurrence risk factors are present, the costs/benefits rapport can be decreased by the laparoscopic approach which offers, in addition to a radical resection, a decreased postoperative pain, reduced trauma to the abdominal wall, smaller incisions, reduced peritoneal adhesions and, in selected cases, an earlier beginning of chemiotherapy. We report the case of a patient affected by more than one HCC with a bigger lesion of 50 mm protruding from hepatic segment III, one subcapsular lesion located at segment V, and one deep lesion located at segment VII-VIII. The patient was submitted to a double laparoscopic liver resection in association with laparoscopic radiofrequency ablation. Five months later, the patient presented an early recurrence of malignancy that was treated by TACE. At 8 months from the treatment, the patient presented another multifocal recurrence and was submitted to another TACE. At 2 years from the laparoscopic procedure, the patient is in apparent good conditions with an acceptable quality of life. We think that laparoscopic resection could gain a considerable place in the multimodal treatment of cirrhotic liver with more than one HCC because, by tumor removing, it offers the benefits of surgical treatment with a lower complications rate.
KW - Hepatocellular carcinoma
KW - Laparoscopic liver resection
KW - Laparoscopic radiofrequency thermoablation
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U2 - 10.1097/SLE.0b013e31806d9c65
DO - 10.1097/SLE.0b013e31806d9c65
M3 - Article
C2 - 17710062
AN - SCOPUS:34548095328
VL - 17
SP - 331
EP - 334
JO - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
JF - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
SN - 1530-4515
IS - 4
ER -