Surgery today · 2016
Simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy for the treatment of hepatocellular carcinoma with cirrhotic hypersplenism.
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Ryu Tomoki, Takami Yuko, Tsutsumi Norifumi, Tateishi Masaki, Mikagi Kazuhiro, Wada Yoshiyuki, Saitsu Hideki
Аннотация
PURPOSE: To establish the efficacy and safety of simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy (Lap-Sp) for the treatment of hepatocellular carcinoma (HCC) with cirrhotic hypersplenism.
METHODS: Seventeen patients with HCC and cirrhotic hypersplenism underwent simultaneous MCN and Lap-Sp at our institution between January, 2010 and July, 2015. Eight and nine patients had Child-Pugh class A and B liver cirrhosis, respectively. The median number of tumors ablated was 1 (range 1-7) and the median largest dimension of the resected lesions was 1.7 cm (range 1.1-3.6 cm). We analyzed postoperative complications and long-term outcomes retrospectively.
RESULTS: The median operating time was 283 min (range 197-418 min) and the median blood loss was 125 mL (range 5-1312 mL). Postoperative morbidity and mortality rates were 29 and 0 %, respectively. The median follow-up time after surgery was 22.5 months (range 4.3-70.9 months). The 1-, 3-, and 5-year disease-free survival rates were 68.8, 10.7, and 10.7 %, respectively, and the 1-, 3-, and 5-year overall survival rates were 88.2, 75.6, and 63.0 %, respectively.
CONCLUSIONS: The findings of this study suggest that simultaneous MCN and Lap-Sp is safe and effective for treating HCC with cirrhotic hypersplenism.
METHODS: Seventeen patients with HCC and cirrhotic hypersplenism underwent simultaneous MCN and Lap-Sp at our institution between January, 2010 and July, 2015. Eight and nine patients had Child-Pugh class A and B liver cirrhosis, respectively. The median number of tumors ablated was 1 (range 1-7) and the median largest dimension of the resected lesions was 1.7 cm (range 1.1-3.6 cm). We analyzed postoperative complications and long-term outcomes retrospectively.
RESULTS: The median operating time was 283 min (range 197-418 min) and the median blood loss was 125 mL (range 5-1312 mL). Postoperative morbidity and mortality rates were 29 and 0 %, respectively. The median follow-up time after surgery was 22.5 months (range 4.3-70.9 months). The 1-, 3-, and 5-year disease-free survival rates were 68.8, 10.7, and 10.7 %, respectively, and the 1-, 3-, and 5-year overall survival rates were 88.2, 75.6, and 63.0 %, respectively.
CONCLUSIONS: The findings of this study suggest that simultaneous MCN and Lap-Sp is safe and effective for treating HCC with cirrhotic hypersplenism.