Interstitial laser coagulation for hepatic tumours.

BACKGROUND

The potential role of interstitial laser coagulation (ILC) for patients with irresectable hepatic tumours is currently being investigated. Since its introduction in 1983 it has evolved into an innovative minimally invasive technique.

METHODS

On the basis of a Medline literature search and the authors' experience, the principles, current state and prospects of ILC for hepatic tumours are reviewed.

RESULTS

Animal studies and early clinical studies have shown the safety and feasibility of ILC. The site of interest can be approached at laparoscopy or percutaneously and treatment is easily repeatable. Recent advances include the use of fibres with a cylindrical diffusing light-emitting tip, the length of which is adaptable to tumour diameter, water-cooled fibre systems, simultaneous multiple fibre application, and hepatic inflow occlusion during laser treatment. ILC allows complete destruction of tumours up to 5 cm in diameter. Currently a limitation is the lack of reliable real-time monitoring of laser-induced effects but progress in magnetic resonance imaging techniques should allow accurate temperature measurements to be obtained rapidly during treatment. However, the actual benefit of ILC in terms of patient survival remains to be investigated.

CONCLUSION

In terms of tools and experience, ILC has now been developed sufficiently to study its effect on survival of patients with irresectable hepatic tumours.