Yamamoto Masahiro, Morishima Kazue, Endo Kazuhiro, Shimodaira Kentaro, Kimura Yuki, Aoki Yuichi, Taguchi Masanobu, Sasanuma Hideki, Sakuma Yasunaru, Watanabe Shunji, Morimoto Naoki, Sata Naohiro
Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Shimotsuke, JPN.
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Jichi Medical University, Shimotsuke, JPN.
Cureus. 2024 Nov 17;16(11):e73864. doi: 10.7759/cureus.73864. eCollection 2024 Nov.
Hepatic resection (HR) and radiofrequency ablation (RFA) are curative treatments for three or fewer hepatocellular carcinomas in Japan. The laparoscopic approach in both has been used in recent years; however, its treatment outcome in combination with HR with RFA is unclear. We aimed to gain insights into this combined treatment.
This was a retrospective study of nine patients with two to three hepatocellular carcinomas who had undergone laparoscopic HR combined with laparoscopic RFA between December 2014 and February 2022. Six patients tested positive for hepatitis C virus, two had alcoholic cirrhosis, and one had non-alcoholic steatohepatitis. All patients had a Child-Pugh score of 5 (A). All 22 lesions were treated as planned. Laparoscopic HR was performed on 12 and laparoscopic RFA was performed on 10 lesions. Postoperative hemorrhage occurred in one patient and was managed conservatively. The remaining eight patients were discharged without complications. Recurrence occurred in the residual liver in eight patients. However, no local recurrence at the treatment site was noted during the observation period (15-94 months).
The treatment combining laparoscopic HR and RFA was feasible for the local control of two to three HCCs and may be useful for preserving residual liver function.
在日本，肝切除术（HR）和射频消融术（RFA）是治疗三枚及以下肝细胞癌的根治性疗法。近年来，二者均采用了腹腔镜入路；然而，其与HR联合RFA的治疗效果尚不清楚。我们旨在深入了解这种联合治疗方法。
这是一项对9例患有两至三枚肝细胞癌患者的回顾性研究，这些患者在2014年12月至2022年2月期间接受了腹腔镜HR联合腹腔镜RFA治疗。6例患者丙型肝炎病毒检测呈阳性，2例患有酒精性肝硬化，1例患有非酒精性脂肪性肝炎。所有患者的Child-Pugh评分为5分（A级）。所有22个病灶均按计划进行了治疗。12个病灶接受了腹腔镜HR治疗，10个病灶接受了腹腔镜RFA治疗。1例患者术后发生出血，经保守治疗。其余8例患者无并发症出院。8例患者在残余肝脏中出现复发。然而，在观察期（15 - 94个月）内未发现治疗部位有局部复发。
腹腔镜HR联合RFA治疗对于两至三枚肝癌的局部控制是可行的，并且可能有助于保留残余肝功能。
