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Thoracoscopic local ablation with diaphragmatic incision method for liver surface tumor in the hepatic dome
Takatoshi Ishiko1, Toru Beppu, Akira Chikamoto
1Department of Gastroenterological Surgery, Graduate School of Faculty of Life Science, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
Purpose:
To assess the feasibility and effectiveness of thoracoscopic local ablation therapy with diaphragmatic incision method.
Background:
Liver tumor in the hepatic dome limits the approach method of ablation. These lesions are accessible through a transdiaphragm, and incision of diaphragm by thoracoscopic surgery might be a valuable option.
Patients And Methods:
Between July 1995 and December 2011, 59 patients with a tumor in the hepatic dome were indicated for thoracoscopic local ablation therapy. The diaphragm above tumor was incised and tumors were ablated thoracoscopically.
Results:
The mean operating time and blood loss was 222 minutes and 33.8 g, respectively. There was no postoperative mortality, and 7 patients with complications recovered successfully. The 5-year overall survival (OS) rate for hepatocellular carcinoma was 51.0%. Local recurrence was suspected in 2 cases.
Conclusions:
Thoracoscopic ablation by incision of the diaphragm represents a feasible approach for the tumor in the hepatic dome with acceptable long-term outcomes.
