General Surgery Unit, Fatebenefratelli-Sacco Hospital, Milan, Italy.
Hepatobiliary Surgery Unit, Department of Surgery, San Paolo Hospital, University of Milan, Via Di Rudinì 8, 20142, Milan, Italy.
Med Oncol. 2020 Mar 19;37(4):32. doi: 10.1007/s12032-020-1342-5.
The optimal treatment for hepatocellular carcinoma (HCC) is surgical resection. However, only a small percentage of patients are amenable to this option. Percutaneous radiofrequency interstitial thermal ablation (TA) proved to be effective in the treatment of unresectable HCC. Recent advances in laparoscopic ultrasound have improved the accuracy in detecting small intrahepatic HCC nodules missed by pre-operative imaging techniques. Our objective was to evaluate an operative combination of laparoscopic ultrasound with laparoscopic thermoablation (LTA) in the treatment of HCC not amenable to liver resection. The aim of our review was to evaluate the advantages and limits of the laparoscopic approach according the criteria of the evidence-based medicine. LTA of HCC proved to be a safe and effective technique both in the short- and long-term follow-up period. This technique may be indicated in selected cases when the percutaneous approach to the lesion is very difficult or contraindicated.
肝细胞癌 (HCC) 的最佳治疗方法是手术切除。然而，只有一小部分患者适合这种方法。经皮射频间质热消融 (TA) 已被证明对不可切除 HCC 的治疗有效。腹腔镜超声的最新进展提高了检测术前影像学检查漏诊的小肝内 HCC 结节的准确性。我们的目的是评估腹腔镜超声与腹腔镜热消融 (LTA) 联合治疗不可切除 HCC 的手术方法。我们的综述旨在根据循证医学的标准评估腹腔镜方法的优点和局限性。在短期和长期随访中，LTA 治疗 HCC 被证明是一种安全有效的技术。在经皮治疗非常困难或禁忌的情况下，该技术可用于某些特定病例。
