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Simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy for the treatment of hepatocellular carcinoma with cirrhotic hypersplenism

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Abstract

Purpose

To establish the efficacy and safety of simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy (Lap-Sp) for the treatment of hepatocellular carcinoma (HCC) with cirrhotic hypersplenism.

Methods

Seventeen patients with HCC and cirrhotic hypersplenism underwent simultaneous MCN and Lap-Sp at our institution between January, 2010 and July, 2015. Eight and nine patients had Child–Pugh class A and B liver cirrhosis, respectively. The median number of tumors ablated was 1 (range 1–7) and the median largest dimension of the resected lesions was 1.7 cm (range 1.1–3.6 cm). We analyzed postoperative complications and long-term outcomes retrospectively.

Results

The median operating time was 283 min (range 197–418 min) and the median blood loss was 125 mL (range 5–1312 mL). Postoperative morbidity and mortality rates were 29 and 0 %, respectively. The median follow-up time after surgery was 22.5 months (range 4.3–70.9 months). The 1-, 3-, and 5-year disease-free survival rates were 68.8, 10.7, and 10.7 %, respectively, and the 1-, 3-, and 5-year overall survival rates were 88.2, 75.6, and 63.0 %, respectively.

Conclusions

The findings of this study suggest that simultaneous MCN and Lap-Sp is safe and effective for treating HCC with cirrhotic hypersplenism.

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan

    Tomoki Ryu, Yuko Takami, Masaki Tateishi, Kazuhiro Mikagi, Yoshiyuki Wada & Hideki Saitsu

  2. Department of Gastroenterological Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

    Norifumi Tsutsumi

Authors
  1. Tomoki Ryu
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  2. Yuko Takami
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  3. Norifumi Tsutsumi
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  4. Masaki Tateishi
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  5. Kazuhiro Mikagi
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  6. Yoshiyuki Wada
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  7. Hideki Saitsu
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Correspondence to Tomoki Ryu.

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Ryu, T., Takami, Y., Tsutsumi, N. et al. Simultaneous microwave coagulo-necrotic therapy (MCN) and laparoscopic splenectomy for the treatment of hepatocellular carcinoma with cirrhotic hypersplenism. Surg Today 47, 548–554 (2017). https://doi.org/10.1007/s00595-016-1411-8

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  • DOI: https://doi.org/10.1007/s00595-016-1411-8

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