부산대학교 도서관

Background: Although a laparoscopic approach for local ablation plays an important role in treating hepatocellular carcinoma (HCC) near the liver surface, precise targeting ablation has been difficult using a conventional linear ultrasonic probe. We have recently developed a sector ultrasonic probe with a guiding tract for precisely targeting tumors. Methods: Since 1996, 349 HCC cases have been treated with either microwave or radiofrequency ablation. A percutaneous approach was selected in 298 cases, and a laparoscopic approach was selected in 51 cases. The laparoscopic approach was selected in the cases in which serious complications due to the tumors being located on the surface or protruding from the liver, or adjacent to the gallbladder or intestine made it difficult to treat percutaneously. In the latest 21 cases, the sector ultrasonic probe was used. Results: All the cases were safely and successfully treated by laparoscopic ablation with an exception by an extensive HCC case with portal vein tumor thrombus. Survival after the treatment by laparoscopic ablation was 95.2% in 1 year, and 82.4% in 3 years. The tumor stage was a significant prognostic factor (P < 0.0001). There was no local recurrence within 6 months of treatment in the successfully treated cases. The use of the sector probe widened indications for the laparoscopic approach for treating HCC. Conclusion: Laparoscopic ablation can result in a satisfactory outcome in difficult-to-treat cases by the percutaneous approach. The newly developed sector ultrasonic probe has allowed us more therapeutic choices in the treatment of HCC. [ABSTRACT FROM AUTHOR]