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

Tanaka, Kimitaka; Kojima, Tetsufumi; Hiraguchi, Etsuo; Hashida, Hideaki; Noji, Takehiro; Hirano, Satoshi

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

Tanaka, Kimitaka; Kojima, Tetsufumi; Hiraguchi, Etsuo et al.

Journal of laparoendoscopic & advanced surgical techniques, 2016, 26(3), 180-184

Permalink : https://hdl.handle.net/2115/64480

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アクセス権	open access
URI	https://hdl.handle.net/2115/64480
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 ; Kojima, Tetsufumi ; Hiraguchi, Etsuo ; Hashida, Hideaki ; Noji, Takehiro ; Hirano, Satoshi
e-Rad_Researcher 10758642 著者名 Tanaka, Kimitaka
著者名 Kojima, Tetsufumi
著者名 Hiraguchi, Etsuo
著者名 Hashida, Hideaki
e-Rad_Researcher 10739296 著者名 Noji, Takehiro
e-Rad_Researcher 50322813 著者名 Hirano, Satoshi
言語	英語
キーワード	Laparoscopic surgery
	Radiofrequency ablation
	Transthoracic transdiaphragmatic approach
	Hepatic tumor
	Diaphragmatic hernia
発行日	2016-03-18
出版者	Mary Ann Liebert
収録物名	Journal of laparoendoscopic & advanced surgical techniques
巻(号)	26(3)
ページ	180-184
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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/lap.2015.0380
PISSN	1092-6429
関連情報	PMID 26859794
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1089/lap.2015.0380