LAPAROSCOPIC ASSISTED PER-CUTANEOUS RADIO-FREQUENCY ABLATION (LAPRFA) AS A NEW MODALITY FOR TREATMENT OF HCC IN...

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Oncology
• Interventional Radiology

Background:

• Hepatocellular carcinoma (HCC) presents challenges in treatment, especially for patients with difficult percutaneous access.
• Existing modalities may not provide adequate assessment or complete tumor ablation in all cases.

Purpose of the Study:

• To evaluate the safety and efficacy of Laparoscopic Assisted Percutaneous Radiofrequency Ablation (LAPRFA) guided by Intra-Operative Laparoscopic Ultrasound (IOLUS) for HCC.
• To assess the added value of IOLUS in liver situation assessment, tumor staging, and treatment effectiveness.

Main Methods:

• Retrospective analysis of 49 HCC patients treated with LAPRFA under IOLUS guidance between September 2010 and July 2014.
• Procedures were guided by multidisciplinary team decisions, with operative time, complications, and hospital stay recorded.
• Postoperative assessment included spiral CT scans and AFP levels.

Main Results:

• LAPRFA was successfully completed in all 49 patients, treating a total of 52 hepatic focal lesions (HFL).
• Intra-operative laparoscopic ultrasound (IOLUS) identified new HFL in three patients, aiding in comprehensive assessment.
• Complete tumor ablation was confirmed intra-operatively and documented postoperatively via CT scan.

Conclusions:

• Laparoscopic assisted percutaneous radiofrequency ablation (LAPRFA) under IOLUS guidance is a safe and effective treatment for hepatocellular carcinoma (HCC).
• This combined approach improves liver assessment, tumor staging, and achieves complete ablation, particularly in challenging cases.