胸腔鏡下MCTの適応とその限界について

概要

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Thoracoscopic microwave coagulation therapy (MCT) is a new therapeutic approach for hepatocellular carcinoma (HCC) in a right subphrenic area of the liver (segments VII and VIII), which allows a minimal access to the tumor and complete tumor ablation. In this study, 19 patients with HCC in segments VII and VIII underwent thoracoscopic MCT as a less invasive therapeutic option due to their advanced liver cirrhosis and/or severe complications. Tumor sizes ranged from 15 to 50 mm in a maximum diameter and tumor differentiation was well differentiated in 3 patients, moderately or poorly in 16 patients. Patients recovered rapidly to preoperative conditions and no mortality was observed. Postoperative computed tomography (CT) showed complete tumor ablation with a cancer-free margin, which is thought to be equivalent to a limited hepatic resection. Postoperative course showed no local recurrence in all patients and no intrahepatic recurrence in 8 patients. This study suggests that thoracoscopic MCT might be a new less invasive option providing a cure for HCC in segments VII and VIII, in patients with advanced liver cirrhosis and severe complications.
特定非営利活動法人 Microwave Surgery研究会の論文