Tomoki Ryu1, Yuko Takami2, Norifumi Tsutsumi3, Masaki Tateishi2, Kazuhiro Mikagi2, Yoshiyuki Wada2, Hideki Saitsu2. 1. Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan. tmk.ryu@kyumed.jp. 2. Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan. 3. Department of Gastroenterological Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Abstract
PURPOSE: To establish the efficacy and safety of simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy (Lap-Sp) for the treatment of hepatocellular carcinoma (HCC) with cirrhotic hypersplenism. METHODS: Seventeen patients with HCC and cirrhotic hypersplenism underwent simultaneous MCN and Lap-Sp at our institution between January, 2010 and July, 2015. Eight and nine patients had Child-Pugh class A and B liver cirrhosis, respectively. The median number of tumors ablated was 1 (range 1-7) and the median largest dimension of the resected lesions was 1.7 cm (range 1.1-3.6 cm). We analyzed postoperative complications and long-term outcomes retrospectively. RESULTS: The median operating time was 283 min (range 197-418 min) and the median blood loss was 125 mL (range 5-1312 mL). Postoperative morbidity and mortality rates were 29 and 0 %, respectively. The median follow-up time after surgery was 22.5 months (range 4.3-70.9 months). The 1-, 3-, and 5-year disease-free survival rates were 68.8, 10.7, and 10.7 %, respectively, and the 1-, 3-, and 5-year overall survival rates were 88.2, 75.6, and 63.0 %, respectively. CONCLUSIONS: The findings of this study suggest that simultaneous MCN and Lap-Sp is safe and effective for treating HCC with cirrhotic hypersplenism.
PURPOSE: To establish the efficacy and safety of simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy (Lap-Sp) for the treatment of hepatocellular carcinoma (HCC) with cirrhotic hypersplenism. METHODS: Seventeen patients with HCC and cirrhotic hypersplenism underwent simultaneous MCN and Lap-Sp at our institution between January, 2010 and July, 2015. Eight and nine patients had Child-Pugh class A and B liver cirrhosis, respectively. The median number of tumors ablated was 1 (range 1-7) and the median largest dimension of the resected lesions was 1.7 cm (range 1.1-3.6 cm). We analyzed postoperative complications and long-term outcomes retrospectively. RESULTS: The median operating time was 283 min (range 197-418 min) and the median blood loss was 125 mL (range 5-1312 mL). Postoperative morbidity and mortality rates were 29 and 0 %, respectively. The median follow-up time after surgery was 22.5 months (range 4.3-70.9 months). The 1-, 3-, and 5-year disease-free survival rates were 68.8, 10.7, and 10.7 %, respectively, and the 1-, 3-, and 5-year overall survival rates were 88.2, 75.6, and 63.0 %, respectively. CONCLUSIONS: The findings of this study suggest that simultaneous MCN and Lap-Sp is safe and effective for treating HCC with cirrhotic hypersplenism.
Authors: Ryan T Groeschl; Charles H C Pilgrim; Erin M Hanna; Kerri A Simo; Ryan Z Swan; David Sindram; John B Martinie; David A Iannitti; Mark Bloomston; Carl Schmidt; Hooman Khabiri; Lawrence A Shirley; Robert C G Martin; Susan Tsai; Kiran K Turaga; Kathleen K Christians; William S Rilling; T Clark Gamblin Journal: Ann Surg Date: 2014-06 Impact factor: 12.969
Authors: T Takayama; M Makuuchi; S Hirohashi; M Sakamoto; J Yamamoto; K Shimada; T Kosuge; S Okada; K Takayasu; S Yamasaki Journal: Hepatology Date: 1998-11 Impact factor: 17.425