Outcome of Laparoscopic Assisted Percutaneous Microwave Ablation for Exophytic Versus Non-exophytic Hepatocellular Carci
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ORIGINAL RESEARCH
Outcome of Laparoscopic Assisted Percutaneous Microwave Ablation for Exophytic Versus Non-exophytic Hepatocellular Carcinoma Mohamed M. Mogahed 1 & Ashraf Anas Zytoon 2
&
Basem Eysa 3 & Mohamed Manaa 3 & Wessam Abdellatif 4
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Hepatocellular carcinoma (HCC) is one of the most common malignancies and is the third cause of cancer-related death worldwide. Surgery is the optimal treatment for early HCC; however, the majority of cases are not suitable for curative resection at the time of diagnosis. Surgical resection difficulties may be related to size, site, number of tumors, extrahepatic involvement, and patient general condition. Exophytic tumors were considered as relative contraindication for thermal ablation because of the risk of incomplete ablation or major complications as hemorrhage and seeding. Aim of this study: to evaluate the safety and efficacy of microwave ablation (MWA) of exophytic HCC in comparison with non-exophytic HCC. Methods Prospective comparative study carried on 30 patients having 30 exophytic (six of those patients had another nonexophytic lesion) and 32 patients having 44 non-exophytic HCC lesions (22 had single lesion, 8 patients had 2 lesions, and 2 patients had 3 lesions) within Milan criteria. All patients were child A or B, they were subjected to full clinical assessment, laboratory investigations, and radiological investigations. Laparoscopic assisted percutaneous MWA was the procedure of choice in our study for all patients either having exophytic or non-exophytic lesions using no-touch wedge technique for exophytic lesions and direct puncture for non-exophytic lesions. Results Technical success was 100% in both groups, all lesions were completely ablated as confirmed by LIOUS. There were no major complications or perioperative mortality and low incidence of local tumor progression in both exophytic and non-exophytic groups. Conclusion Laparoscopic assisted MWA of exophytic HCC is safe and effective with comparable results to non-exophytic HCC. Exophytic HCC is not contraindication for MWA with proper technique selection. Keywords Exophytic HCC . Microwave ablation . Laparoscopic surgery
Introduction Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world, HCC is the third most common cause of cancer-related death worldwide [1]. * Ashraf Anas Zytoon [email protected] 1
Surgical Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
2
Radiodiagnosis Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3
Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
4
Radiology Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
Surgery is the optimal treatment for early HCC; however, the majority of primary liver cancers are not suitable for curative resection at the time of diagnosis. Surgical re
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