Volume 7, Issue 5, October 2019, Page: 132-137
Laparoscopic Assisted Percutaneous Microwave Ablation for Hepatocellular Carcinoma Close to Large Hepatic Vessels
Mohamed Mogahed, Surgical Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt
Bahaa El Wakeel, Surgical Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt
Ashraf El Kholy, Surgical Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt
Wessam Moustafa Abdellatif, Radiology Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt
Ashraf Anas Zytoon, Radiodiagnosis Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Mohamed Manaa, Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt
Nashwa Said Ghanem, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Received: May 13, 2019;       Accepted: Jun. 25, 2019;       Published: Aug. 29, 2019
DOI: 10.11648/j.js.20190705.14      View  34      Downloads  8
Abstract
Background: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. It was believed that ablation for tumors close to large vessels should be avoided for the concern of major complications. Microwave ablation (MWA) seemed to be a better choice than radiofrequency ablation (RFA) in treating HCC close to large vessels (≥ 3 mm), for its advantages of a lower susceptibility to heat-sink effects (blood-vessel-mediated cooling), as well as the ability to achieve larger tumor volumes in shorter time. The aim of this study is to evaluate safety and efficacy of MWA for HCC close to large vessels. Methods: 32 patients with 52 HCC lesions were included, all patients have a lesion close to large vessel. 14 patients had single lesion, 16 had two lesions and 2 had three lesions. All patients are Child-Pugh A or B within Milan Criteria and class A disease Barcelona Clinic Liver Cancer (BCLC). Results: This study was conducted on 32 HCC patients 24 males and 8 females with median age 63 years. 32 HCC lesions were close to large vessel while 20 lesions were not close to large vessel. Laparoscopic assisted percutaneous MWA was decided as the treatment of choice for all patients. two patients (6%) had major complications (one patient had right portal vein thrombosis and the other patient had intra-hepatic hematoma), 3 patients (9%) had minor complications in the form of skin burn. Local tumor progression (LTP) occurred in 2 lesions (3.8% of lesions). Conclusion: laparoscopic assisted percutaneous MWA proved to be a safe and effective as a management for HCC close to large vessels.
Keywords
Laparoscopic Assisted Percutaneous, Microwave Ablation, Hepatocellular Carcinoma
To cite this article
Mohamed Mogahed, Bahaa El Wakeel, Ashraf El Kholy, Wessam Moustafa Abdellatif, Ashraf Anas Zytoon, Mohamed Manaa, Nashwa Said Ghanem, Laparoscopic Assisted Percutaneous Microwave Ablation for Hepatocellular Carcinoma Close to Large Hepatic Vessels, Journal of Surgery. Vol. 7, No. 5, 2019, pp. 132-137. doi: 10.11648/j.js.20190705.14
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Himoto T, Kurokohchi K, Watanabe S, Masaki T. Recent advances in radiofrequency ablation for the management of hepatocellular carcinoma. Hepat Mon. 2012; 12: e5945. [PMC free article] [PubMed].
[2]
Atti EA (2015) HCC Burden in Egypt. Gastroentero J Hepatol Open Access 2 (3): 00045.
[3]
Fong Y, Sun RL, Jarnagin W, Blumgart LH. An analysis of 412 cases of hepatocellular carcinoma at a Western centre. Ann Surg. 1999; 229: 790–799.; discussion 799–800.
[4]
Sakaguchi H, Seki S, Tsuji K, Teramoto K, Suzuki M, Kioka K, et al. Endoscopic thermal ablation therapies for hepatocellular carcinoma: a multi-centre study. Hepatol Res. 2009; 39: 47–52. [PubMed].
[5]
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005; 55: 74–108. [PubMed].
[6]
Yang JD, Roberts LR. Epidemiology and management of hepatocellular carcinoma. Infect Dis Clin North Am. 2010; 24: 899–919, viii. [PMC free article] [PubMed].
[7]
Forner A, Reig ME, de Lope CR, Bruix J. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis. 2010; 30: 61–74. [PubMed].
[8]
Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology. 2005; 42: 1208–1236. [PubMed].
[9]
Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology. 2011; 53: 1020–1022.
[10]
Brace CL. Radiofrequency and microwave ablation of the liver, lung, kidney, and bone: what are the differences? Curr Probl Diagn Radiol. 2009; 38: 135–143. [PMC free article] [PubMed].
[11]
Simon CJ, Dupuy DE, Mayo-Smith WW. Microwave ablation: principles and applications. Radiographics. 2005; 25 Suppl 1: S69–S83. [PubMed].
[12]
Yu NC, Raman SS, Kim YJ, Lassman C, Chang X, Lu DS. Microwave liver ablation: influence of hepatic vein size on heat-sink effect in a porcine model. J Vasc Interv Radiol. 2008; 19: 1087–1092. [PubMed].
[13]
Lloyd DM, Lau KN, Welsh F, Lee KF, Sherlock DJ, Choti MA, Martinie JB, Iannitti DA. International multicentre prospective study on microwave ablation of liver tumours: preliminary results. HPB (Oxford) 2011; 13: 579–585.
[14]
Ahmed M, Solbiati L, Brace CL, Breen DJ, Callstrom MR, Charboneau JW, Chen MH, Choi BI, de Baère T, Dodd GD 3rd, Dupuy DE, Gervais DA, Gianfelice D, et al. Imageguided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. Radiology. 2014; 273: 241–60.
[15]
Facciorusso A, Serviddio G, Muscatiello N. Local ablative treatments for hepatocellular carcinoma: An updated review. World J Gastrointest Pharmacol Ther. 2016 Nov 6; 7 (4): 477-489. Review.
[16]
McWilliams JP, Yamamoto S, Raman SS, Loh CT, Lee EW, Liu DM, Kee ST. Percutaneous ablation of hepatocellular carcinoma: current status. J Vasc Interv Radiol. 2010; 21: S204–S213.
[17]
Simo KA, Sereika SE, Newton KN, Gerber DA. Laparoscopic-assisted microwave ablation for hepatocellular carcinoma: safety and efficacy in comparison with radiofrequency ablation. J Surg Oncol. 2011 Dec; 104 (7): 822-9. doi: 10.1002/jso.21933. Epub 2011 Apr 25. PMID: 21520094.
[18]
Dong B, Liang P, Yu X, Su L, Yu D, Cheng Z, Zhang J. Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients. AJR Am J Roentgenol. 2003; 180: 1547–1555. [PubMed].
[19]
Liang P, Dong B, Yu X, Yu D, Wang Y, Feng L, Xiao Q. Prognostic factors for survival in patients with hepatocellular carcinoma after percutaneous microwave ablation. Radiology. 2005; 235: 299–307. [PubMed].
[20]
Lu MD, Chen JW, Xie XY, Liu L, Huang XQ, Liang LJ, Huang JF. Hepatocellular carcinoma: US-guided percutaneous microwave coagulation therapy. Radiology. 2001; 221: 167–172. [PubMed].
[21]
Livraghi T, Meloni F, Solbiati L, Zanus G; Collaborative Italian Group using AMICA system. Complications of microwave ablation for liver tumors: results of a multicenter study. Cardiovasc Intervent Radiol. 2012; 35: 868–874. [PubMed].
[22]
Chiang J, Cristescu M, Lee MH, Moreland A, Hinshaw JL, Lee FT, Brace CL. Effects of Microwave Ablation on Arterial and Venous Vasculature after Treatment of Hepatocellular Carcinoma. Radiology. 2016 Nov; 281 (2): 617-624. Epub 2016 Jun 3. PMID: 27257951.
[23]
Perisic M, Ilic-Mostic T, Stojkovic M, Culafic D, Sarenac R. Doppler hemodynamic study in portal hypertension and hepatic encephalopathy. Hepatogastroenterology 2005; 52 (61): 156–160.
[24]
Chiang J, Hynes K, Brace CL. Flow-dependent vascular heat transfer during microwave thermal ablation. Conf Proc IEEE Eng Med Biol Soc 2012; 2012: 5582–5585.
[25]
Abdelaziz A, Elbaz T, Shousha HI, Mahmoud S, Ibrahim M, Abdelmaksoud A, Nabeel M. Efficacy and survival analysis of percutaneous radiofrequency versus microwave ablation for hepatocellular carcinoma: an Egyptian multidisciplinary clinic experience. Surg Endosc. 2014; 28: 3429–3434. [PubMed].
[26]
Vogl TJ, Farshid P, Naguib NN, Zangos S, Bodelle B, Paul J, Mbalisike EC, Beeres M, Nour-Eldin NE. Ablation therapy of hepatocellular carcinoma: a comparative study between radiofrequency and microwave ablation. Abdom Imaging. 2015; 40: 1829–1837. [PubMed].
[27]
Zhang L, Wang N, Shen Q, Cheng W, Qian GJ. Therapeutic efficacy of percutaneous radiofrequency ablation versus microwave ablation for hepatocellular carcinoma. PLoS One. 2013; 8: e76119. [PMC free article] [PubMed].
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