Technical and Clinical Outcomes of Laparoscopic–Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of Literature
Purpose: To evaluate technical and clinical outcomes of intraoperative (laparoscopic/laparotomic) microwave ablation on HCC. Materials and Methods: This is a retrospective single-center study evaluating consecutive patients treated for very early/early-stage HCC with intraoperative microwave ablatio...
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| Format: | Article |
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MDPI AG
2023-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/1/92 |
| _version_ | 1797359034749157376 |
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| author | Riccardo Muglia Paolo Marra Domenico Pinelli Ludovico Dulcetta Francesco Saverio Carbone Alessandro Barbaro Antonio Celestino Michele Colledan Sandro Sironi |
| author_facet | Riccardo Muglia Paolo Marra Domenico Pinelli Ludovico Dulcetta Francesco Saverio Carbone Alessandro Barbaro Antonio Celestino Michele Colledan Sandro Sironi |
| author_sort | Riccardo Muglia |
| collection | DOAJ |
| description | Purpose: To evaluate technical and clinical outcomes of intraoperative (laparoscopic/laparotomic) microwave ablation on HCC. Materials and Methods: This is a retrospective single-center study evaluating consecutive patients treated for very early/early-stage HCC with intraoperative microwave ablation from 1 July 2017 to 30 June 2023. In these patients, a percutaneous US-guided approach was excluded due to the nodule’s suboptimal visibility or harmful location and liver resection for a deep position or adherences. Data about the clinical stage, surgical approach, liver pathology and nodules characteristics, technical success, complications, and follow-up were collected. Technical success was intended as the absence of locoregional persistence at follow-up CT/MRI controls. Results: A total of 36 cirrhotic patients (M:F = 30:6, median age 67 years) were enrolled; 18/36 (50%) had a single nodule, 13/36 (36%) had two, 4/36 had three (11%), and 1/36 had four (3%). Among the patients, 24 (67%) were treated with laparoscopy, and 12/36 (33%) with a laparotomic approach. Sixty HCCs of 16.5 mm (6–50 mm) were treated for 7 min (2–30 min) with 100 W of power. A total of 55 nodules (92%) were treated successfully and showed no residual enhancement at the first postoperative follow-up; the other 5/60 (8%) underwent chemo/radioembolization. There was one complication (3%): a biliary fistula treated with percutaneous drainage and glue embolization. The average hospital stay was 3.5 days (1–51 days), and patients were followed up on average for 238 days (13–1792 days). During follow-up, 5/36 patients (14%) underwent liver transplantation, 1/36 (2%) died during hospitalization and 1 after discharge. Conclusions: Laparoscopic/laparotomic intraoperative HCC MW ablation is feasible in patients unsuitable for percutaneous approach or hepatic resection, with rare complications and with good technical and clinical outcomes. |
| first_indexed | 2024-03-08T15:10:50Z |
| format | Article |
| id | doaj.art-e84b7a6eebc745f099896cb9ea394612 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-08T15:10:50Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e84b7a6eebc745f099896cb9ea3946122024-01-10T14:52:41ZengMDPI AGCancers2072-66942023-12-011619210.3390/cancers16010092Technical and Clinical Outcomes of Laparoscopic–Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of LiteratureRiccardo Muglia0Paolo Marra1Domenico Pinelli2Ludovico Dulcetta3Francesco Saverio Carbone4Alessandro Barbaro5Antonio Celestino6Michele Colledan7Sandro Sironi8Department of Radiology, Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyDepartment of Radiology, Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyDepartment of General Surgery, Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyDepartment of Radiology, Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyDepartment of Radiology, Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalySchool of Medicine, University of Milano-Bicocca, 20126 Milano, ItalySchool of Medicine, University of Milano-Bicocca, 20126 Milano, ItalyDepartment of General Surgery, Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyDepartment of Radiology, Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyPurpose: To evaluate technical and clinical outcomes of intraoperative (laparoscopic/laparotomic) microwave ablation on HCC. Materials and Methods: This is a retrospective single-center study evaluating consecutive patients treated for very early/early-stage HCC with intraoperative microwave ablation from 1 July 2017 to 30 June 2023. In these patients, a percutaneous US-guided approach was excluded due to the nodule’s suboptimal visibility or harmful location and liver resection for a deep position or adherences. Data about the clinical stage, surgical approach, liver pathology and nodules characteristics, technical success, complications, and follow-up were collected. Technical success was intended as the absence of locoregional persistence at follow-up CT/MRI controls. Results: A total of 36 cirrhotic patients (M:F = 30:6, median age 67 years) were enrolled; 18/36 (50%) had a single nodule, 13/36 (36%) had two, 4/36 had three (11%), and 1/36 had four (3%). Among the patients, 24 (67%) were treated with laparoscopy, and 12/36 (33%) with a laparotomic approach. Sixty HCCs of 16.5 mm (6–50 mm) were treated for 7 min (2–30 min) with 100 W of power. A total of 55 nodules (92%) were treated successfully and showed no residual enhancement at the first postoperative follow-up; the other 5/60 (8%) underwent chemo/radioembolization. There was one complication (3%): a biliary fistula treated with percutaneous drainage and glue embolization. The average hospital stay was 3.5 days (1–51 days), and patients were followed up on average for 238 days (13–1792 days). During follow-up, 5/36 patients (14%) underwent liver transplantation, 1/36 (2%) died during hospitalization and 1 after discharge. Conclusions: Laparoscopic/laparotomic intraoperative HCC MW ablation is feasible in patients unsuitable for percutaneous approach or hepatic resection, with rare complications and with good technical and clinical outcomes.https://www.mdpi.com/2072-6694/16/1/92thermal ablationhepatocellular carcinomalaparoscopylaparotomymicrowave ablation |
| spellingShingle | Riccardo Muglia Paolo Marra Domenico Pinelli Ludovico Dulcetta Francesco Saverio Carbone Alessandro Barbaro Antonio Celestino Michele Colledan Sandro Sironi Technical and Clinical Outcomes of Laparoscopic–Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of Literature Cancers thermal ablation hepatocellular carcinoma laparoscopy laparotomy microwave ablation |
| title | Technical and Clinical Outcomes of Laparoscopic–Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of Literature |
| title_full | Technical and Clinical Outcomes of Laparoscopic–Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of Literature |
| title_fullStr | Technical and Clinical Outcomes of Laparoscopic–Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of Literature |
| title_full_unstemmed | Technical and Clinical Outcomes of Laparoscopic–Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of Literature |
| title_short | Technical and Clinical Outcomes of Laparoscopic–Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of Literature |
| title_sort | technical and clinical outcomes of laparoscopic laparotomic hepatocellular carcinoma thermal ablation with microwave technology case series and review of literature |
| topic | thermal ablation hepatocellular carcinoma laparoscopy laparotomy microwave ablation |
| url | https://www.mdpi.com/2072-6694/16/1/92 |
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