開腹下MCTは肝部下大静脈に接する大型肝細胞癌に対しても奏効する

概要

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Microwave coagulo-necrotic therapy (MCT) have been realised ablation of hepatic tumor ensuring the tumor free margin without taking too many risks. It is the feature of MCT distinguished from any other minimal invasive therapy, including percutaneous ethanol injection therapy (PEIT) and transarterial chemoembolization (TACE) for hepatocellular carcinoma. But the lesions adjacent to the inferior vena cava (IVC) or the hepatic hilar portion are thought to be not good candidates for MCT on account of injuring these structures in ease.We report a treated case of HCC adjacent to the IVC. Initially, TACE applied because of poor hepatic functional reserve, but TACE showed an insufficient effect, and MCT underwent secondary. After laparotomy, we performed 63 times punctures of the needle and coagulation to the tumor, and accomplished complete ablation to the tumor just front of the IVC. After 2 months from the open MCT, the lesions were enclosed within the coagulating area and no carcinoma recurence has been found for 2 years after these procedures.This result from the case demonstrates that the MCT for the lesions neighboring the paracaval portion of the liver is one of useful procedures within the multidiscipliary approach to the hepatocellular caricinoma.