Intraoperative abdominal ultrasonography-guided large volume ethanol injection for hepatocellular carcinoma

Autor: Alejandro Mondragon-Sanchez, Ricardo Mondragón-Sánchez, Mauricio Frias-Mendivil, Ana Lilia L. Gardu o-Lopez, Rubi Espejo, Hector Murrieta, Rigoberto Bernal-Maldonado
Rok vydání: 2001
Předmět:
Zdroj: Gastroenterology. 120:A482
ISSN: 0016-5085
DOI: 10.1016/s0016-5085(08)82388-8
Popis: was completed successfully on lesions in segments 1,2,3,5,6,7 and 8. One patient was converted to open in order to address tumor extending into an adjacent segment of colon. Another patient underwent planned trans-diaphragmatic ablation of a lesion in the dome of the liver during thoracotomy for a synchronous lung lesion. There were no immediate or late complications. After a mean follow-up of 6.4 months there were no recurrences. One port site metastasis occurred and one patient had 4 new lesions discovered eight months after surgery. Laparoscopic cryosurgery was completed on lesions in segments 2,3,4,6,7 and 8. Two patients required conversion from laparoscopy; one for dense adhesions and the other for safe exposure of a segment 6 lesion abutting the stomach. Three Patients suffered complications from cryosurgery including two post-operative deaths. After a mean follow-up of 9.3 months there was one recurrence. The average length of hospitalization (LOH) was greatest for those who underwent open surgery at 8.0 days. For cryosurgery performed laparoscopically the average LOH was 4.4 days, and for laparoscopic RFA 1.8 days. Conclusions Every segment of the liver is accessible to laparoscopic tumor destruction. In experienced hands and under ultrasound guidance laparoscopic RFA can be performed with excellent results, short hospitalization and minimal complicaions.
Databáze: OpenAIRE
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