[Radio-frequency ablation (RFA) assisted endoscopic hepatectomy for hepatocellular carcinoma]

We introduced a new therapeutic approach for hepatocellular carcinoma (HCC); Radio-frequency ablation (RFA) assisted endoscopic hepatectomy (RFA-assisted EH). Seven patients with HCC, smaller than 3 cm and located on the surface of the liver, were entered into this study. RFA on the hepatic cutting line was achieved with a 2 cm Cool-tip needle at a 1-cm interval. RFA power was gradually increased to 100 W in a minute and ablation was stopped once an impedance-out state was attained of RFA power. Hepatic resection was achieved with various items in a coagulative hepatic parenchyma. If necessary, additional RFA could be performed during the hepatectomy. Patients' characteristics were described as follows; average age: 64 years, 5 males and 2 females, liver damage A: 5, B: 2, average tumor size: 27 mm, and average tumor number: 1.3 Two thoracoscopic and 5 laparoscopic approaches were selected. One application of RFA could make an elliptical coagulative area (2 cm x 1 cm). RFA was achieved eleven times on the hepatic cutting line and three times during the hepatectomy. The average operating time and blood loss was 256 minutes and 96 g, respectively. No blood product was needed. The average postoperative hospital stay was 11 days and no operative complication was encountered. All of the patients were well and without recurrence during the observation period (average: 6 months). We positively recommend RFA-assisted EH for HCC due to its perfect radicality and safety.