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Laparoscopic Assisted Percutaneous Microwave Ablation for Hepatocellular Carcinoma Close to Large Hepatic Vessels

Received: 13 May 2019     Accepted: 25 June 2019     Published: 29 August 2019
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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.

Published in Journal of Surgery (Volume 7, Issue 5)
DOI 10.11648/j.js.20190705.14
Page(s) 132-137
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Laparoscopic Assisted Percutaneous, Microwave Ablation, Hepatocellular Carcinoma

References
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Cite This Article
  • APA Style

    Mohamed Mogahed, Bahaa El Wakeel, Ashraf El Kholy, Wessam Moustafa Abdellatif, Ashraf Anas Zytoon, et al. (2019). Laparoscopic Assisted Percutaneous Microwave Ablation for Hepatocellular Carcinoma Close to Large Hepatic Vessels. Journal of Surgery, 7(5), 132-137. https://doi.org/10.11648/j.js.20190705.14

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    ACS Style

    Mohamed Mogahed; Bahaa El Wakeel; Ashraf El Kholy; Wessam Moustafa Abdellatif; Ashraf Anas Zytoon, et al. Laparoscopic Assisted Percutaneous Microwave Ablation for Hepatocellular Carcinoma Close to Large Hepatic Vessels. J. Surg. 2019, 7(5), 132-137. doi: 10.11648/j.js.20190705.14

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    AMA Style

    Mohamed Mogahed, Bahaa El Wakeel, Ashraf El Kholy, Wessam Moustafa Abdellatif, Ashraf Anas Zytoon, et al. Laparoscopic Assisted Percutaneous Microwave Ablation for Hepatocellular Carcinoma Close to Large Hepatic Vessels. J Surg. 2019;7(5):132-137. doi: 10.11648/j.js.20190705.14

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  • @article{10.11648/j.js.20190705.14,
      author = {Mohamed Mogahed and Bahaa El Wakeel and Ashraf El Kholy and Wessam Moustafa Abdellatif and Ashraf Anas Zytoon and Mohamed Manaa and Nashwa Said Ghanem},
      title = {Laparoscopic Assisted Percutaneous Microwave Ablation for Hepatocellular Carcinoma Close to Large Hepatic Vessels},
      journal = {Journal of Surgery},
      volume = {7},
      number = {5},
      pages = {132-137},
      doi = {10.11648/j.js.20190705.14},
      url = {https://doi.org/10.11648/j.js.20190705.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190705.14},
      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.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Laparoscopic Assisted Percutaneous Microwave Ablation for Hepatocellular Carcinoma Close to Large Hepatic Vessels
    AU  - Mohamed Mogahed
    AU  - Bahaa El Wakeel
    AU  - Ashraf El Kholy
    AU  - Wessam Moustafa Abdellatif
    AU  - Ashraf Anas Zytoon
    AU  - Mohamed Manaa
    AU  - Nashwa Said Ghanem
    Y1  - 2019/08/29
    PY  - 2019
    N1  - https://doi.org/10.11648/j.js.20190705.14
    DO  - 10.11648/j.js.20190705.14
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 132
    EP  - 137
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20190705.14
    AB  - 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.
    VL  - 7
    IS  - 5
    ER  - 

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Author Information
  • Surgical Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt

  • Surgical Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt

  • Surgical Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt

  • Radiology Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt

  • Radiodiagnosis Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

  • Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute “NHTMRI”, Cairo, Egypt

  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

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