切除不能肝癌に対する開腹下microwave凝固壊死療法

概要

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From October 1983 to January 1995, we performed microwave coagulo-necrotic therapy (MCN) in 21 patients in whom another cancer nodules were detected intraoperatively or liver resection was dangerous due to severe cirrhosis. Seven were treated with MCN alone, other 13 cases were treated with MCN combined with partial hepatic resection, and one case was done with portal vein ligation. Preoperative results of fifteen minutes retention rate of indocyanine green were 6.4 to 45.8 (mean ; 27.0) %. The needle-electrode was punctured into various site of the tumor one to fifty times, and coagulations with microwave energy of 80 watts for 30 seconds at 15 seconds intervals were done. The treated lesions changed to avascular areas on dynamic CT at 1 and 6 postoperative months, and these lesions were completely necrotic histologically. The postoperative courses of 7 patients who received MCN therapy alone were uncomplicated except for one patient with severe cirrhosis. Long term prognosis after MCN were almost the same as that after liver resection. MCN is useful for treatment of unresectable HCC with minimal invasiveness.