Postoperative Outcomes of Laparoscopic Hepatic Resection Combined With Radiofrequency Ablation for Two or Three Hepatocellular Carcinomas: A Case Series of Nine Patients

Introduction: 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.

Case presentation: 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).

Conclusion: 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.