Laparoscopic microwave coagulation therapy for hepatocellular carcinoma

Background and Study Aims: Several different effective forms of treatment a re available, singly or in combination, for patients with hepatocellular ca rcinoma (HCC). These include surgical resection, transcatheter arterial emb olization, percutaneous ethanol injection, and percutaneous microwave coagu lation therapy: In this study, we carried out laparoscopic microwave coagul ation therapy (LMCT), using laparoscopic microwave electrodes to treat HCC. Patients and Methods: Under local anesthesia, 24 patients with HCCs located on or near the liver surface underwent LMCT under direct laparoscopic visi on, with ultrasound guidance. LMCT was performed using microwave electrodes with tips ranging from 15-45 mm in length, and the effectiveness of the tr eatment was confirmed using contrast-enhanced computed tomography (CT) with in two weeks of the LMCT procedure. Results: The mean longest asis of the 26 HCC nodules in 24 patients was 20 mm, and that of the coagulated areas including the nodules was 40 mm, with additional therapy being required in two patients. Complete efficacy of the treatment was observed in 21 patients (87.5%), but local recurrences were seen in three of them one year after LMCT. The three-year survival rate was 92 %, but the number of patients included in the study was small. Hemostas is was complete, but mild pneumothorax occurred in three patients. Conclusions: LMCT under local anesthesia is a minimally invasive and effect ive therapy when carried out on a single occasion to treat HCCs located nea r the liver surface, and it can be safely pel formed under direct visual gu idance.