Laparoscopic and thoracoscopic approaches for the treatment of hepatocellular carcinoma

Am J Surg. 2005 Apr;189(4):474-8. doi: 10.1016/j.amjsurg.2004.09.018.

Abstract

Background: Laparoscopic/thoracoscopic intervention has been recently developed for hepatocellular carcinoma (HCC). However, no precise evaluation regarding this type of surgery has been performed.

Patients and methods: A total of 33 laparoscopic and thoracoscopic treatments were performed on HCC patients, laparoscopic or thoracoscopic liver resection (LTR) in 15 patients and laparoscopic or thoracoscopic thermal ablation (LTA) in 18 patients.

Results: Postoperative hospital stay was 12.7 days after resection and 14.8 days after ablation. The 1- and 3- year actuarial survival rate were 100% and 80%, respectively, after LTR and 95% and 75%, respectively, after LTA. The 1- and 3- year disease-free survival rates were 75% and 40%, respectively, after LTR, and 60% and 28%, respectively, after LTA.

Conclusion: LTR has the advantages of the curability of open surgery and less invasiveness of laparoscopic surgery. LTA is useful for tumors that cannot be percutaneously detected by ultrasound. Laparoscopic/thoracoscopic intervention is therefore considered an alternative means of treatment for selected HCC patients.

Publication types

  • Comparative Study

MeSH terms

  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / methods*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hepatectomy / adverse effects
  • Hepatectomy / methods
  • Humans
  • Japan
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Thoracoscopy / adverse effects
  • Thoracoscopy / methods*
  • Treatment Outcome