Interstitial laser coagulation for hepatic tumours

Background: The potential role of interstitial laser coagulation (ILC) for patients with irresectable hepatic tumours is currently being investigated. Since its introduction in 1983 it has evolved into an innovative minimally in invasive technique. Methods: On the basis of a A Medline literature search and the authors' exp erience, the principles, current state and prospects of ILC for hepatic tum ours are reviewed. Results: Animal studies and early clinical studies have shown the safety an d feasibility of ILC. The site of interest can be approached at laparoscopy or percutaneously and treatment is easily repeatable. Recent advances incl ude the use of fibres with a cylindrical diffusing light-emitting tip, the length of which is adaptable to tumour diameter, water-cooled fibre systems , simultaneous multiple fibre application, and hepatic inflow occlusion dur ing laser treatment. ILC allows complete destruction of tumours up to 5 cm in diameter, Currently a limitation is the lack of reliable real-time monit oring of laser-induced effects but progress in magnetic resonance imaging t echniques should allow accurate temperature measurements to be obtained rap idly during treatment. However, the actual benefit of ILC in terms of patie nt survival remains to be investigated. Conclusion: In terms of tools and experience, ILC has now been developed su fficiently to study its effect on survival of patients with irresectable he patic tumours.