Laparoscopic Ultrasound-Guided Radiofrequency Ablation as a Bridge to Liver Transplantation for Hepatocellular Carcinoma: Preliminary Results
| Autor: | F. Panaro, Nazario Portolani, T. Piardi, P. Wolf, F. Gheza, M. Audet, M.L. Woehl-Jaegle, J. Cinqualbre |
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| Rok vydání: | 2010 |
| Předmět: |
Ablation Techniques
Liver Cirrhosis Male medicine.medical_specialty Carcinoma Hepatocellular Cirrhosis Radiofrequency ablation Biopsy medicine.medical_treatment Liver transplantation law.invention law medicine Carcinoma Aged Hepatocellular Female Humans Laparoscopy Liver Neoplasms Liver Transplantation Middle Aged Retrospective Studies alpha-Fetoproteins Neoadjuvant therapy Ultrasonography Transplantation medicine.diagnostic_test business.industry respiratory system medicine.disease Endoscopy Surgery carbohydrates (lipids) stomatognathic diseases Hepatocellular carcinoma lipids (amino acids peptides and proteins) Radiology Liver cancer business |
| Zdroj: | Transplantation Proceedings. 42:1179-1181 |
| ISSN: | 0041-1345 |
| Popis: | The aim of this study was to assess the impact of laparoscopic thermoablation (LTA) as a neoadjuvant therapy prior to orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).Between January 2008 and January 2009, 12 consecutive patients, including 10 males and 2 females with unresectable HCC within liver cirrhosis, were treated with LTA under ultrasound (US) guidance. Most patients were in Child-Pugh class B (54.1%) with a mean age of 60.7 +/- 7.74 years (range, 45-69; median, 60).The LTA procedure was completed in all patients with thermoablation of 23 HCC nodules. LTA identified 4 new malignant lesions (20%) undetected by preoperative imaging (0.5 cm). The mean length of surgery was 96 minutes (range, 45-118). Six procedures were performed in 4 patients. No postoperative hepatic insufficiency was reported. The mean hospital stay was 4.5 days; no postoperative morbidity was reported. Complete tumor necrosis was achieved in 19/23 thermoablated nodules (82.6%) as evidenced computed tomography (CT) scan by at 3 weeks after the treatment. All patients underwent OLT without complications. The histology of the native liver showed complete necrosis in 17/23 (74%) treated nodules.There is currently no convincing evidence that LTA allows one to expand the current selection criteria for OLT, nor that LTA decreases dropout rates on the waiting list. However, LTA does not increase the risk of postoperative complications. There is insufficient evidence that LTA offers any benefit when used prior to OLT either for early or for advanced HCC. |
| Databáze: | OpenAIRE |
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