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Laparoscopy-Guided Transthoracic Transdiaphragmatic Radiofrequency Ablation for Hepatic Tumors Located Beneath the Diaphragm

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タイトル: Laparoscopy-Guided Transthoracic Transdiaphragmatic Radiofrequency Ablation for Hepatic Tumors Located Beneath the Diaphragm
その他のタイトル: Laparoscopic transdiaphragmatic RFA for hepatic tumor
著者: Tanaka, Kimitaka 著作を一覧する
Kojima, Tetsufumi 著作を一覧する
Hiraguchi, Etsuo 著作を一覧する
Hashida, Hideaki 著作を一覧する
Noji, Takehiro 著作を一覧する
Hirano, Satoshi 著作を一覧する
キーワード: Laparoscopic surgery
Radiofrequency ablation
Transthoracic transdiaphragmatic approach
Hepatic tumor
Diaphragmatic hernia
発行日: 2016年 3月18日
出版者: Mary Ann Liebert
誌名: Journal of laparoendoscopic & advanced surgical techniques
巻: 26
号: 3
開始ページ: 180
終了ページ: 184
出版社 DOI: 10.1089/lap.2015.0380
抄録: Background: It is often difficult to perform percutaneous radiofrequency ablation (RFA) for hepatic tumors beneath the diaphragm. Diaphragmatic thermal damage is one of the fatal late complications of percutaneous transdiaphragmatic RFA. Our experience with laparoscopic transthoracic transdiaphragmatic intraoperative RFA (LTTI-RFA) for hepatic tumors beneath the diaphragm is reported. Methods: Ten patients who underwent LTTI-RFA from 2009 to 2012 were evaluated. Two cases had concomitant partial hepatectomy, and one underwent RFA for two tumors at the same time. The diagnosis was hepatocellular carcinoma in eight cases and metastatic hepatic tumors in two cases. Nine of eleven tumors were located at segments 7 and 8. Nine tumors were less than 20 mm in diameter. The patients were placed in the half left lateral decubitus position with single-lumen tube intubation. After placement of four abdominal ports, a 12-mm port was inserted in the fourth or fifth intercostal space into the diaphragm. The tumor was ablated by an RFA needle through the port. The routine follow-up consisted of laboratory tests and abdominal imaging every 3-6 months. Results: The median operation time for only one tumor was 137 minutes (range, 105-187 minutes). The median number of times for ablation was three. Severe postoperative complications (>Clavien-Dindo IIIa) were observed in one case (right upper limb paralysis). The median follow-up period was 35 months (range, 11-43 months). There was no local tumor progression. Recurrent hepatic tumor appearance occurred in other parts of the liver in 6 of the 11 patients. Conclusions: Laparoscopic transthoracic transdiaphragmatic RFA is an acceptable procedure with a low rate of local recurrence.
Rights: Final publication is available from Mary Ann Liebert, Inc., publishers
資料タイプ: article (author version)
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 田中 公貴


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