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Initial experiences with MR Image-guided laparoscopic microwave coagulation therapy for hepatic tumors

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Abstract

Purpose

Percutaneous thermal ablation is used for treating hepatic tumors. Recent advances in laparoscopy and imaging modalities have led to the development of a novel image-guided minimally invasive loco-regional treatment. The aim of this trial was to apply laparoscopic assistance to magnetic resonance (MR) image-guided thermoablation instead of ultrasonography, because of its various advantages.

Methods

Patients with hepatic tumors and liver cirrhosis underwent magnetic resonance (MR) image-guided laparoscopic microwave coagulation therapy using a borescope and endoscopic forceps. Six cases of laparoscopic microwave coagulation treatment using MR image guidance were successfully performed between January 2000 and December 2008. Tumors were detected, punctured, and ablated in an open-configured MR scanner. A total of nine hepatocellular carcinoma nodules were preoperatively identified in S3, S5 and S6 (mean diameter = 20.8 ± 5.4 mm).

Results

MR-guided microwave coagulation was laparoscopically achieved in all patients without any significant complications that required invasive treatment. The mean length of the operation was 275.3 ± 60.5 min, and the mean postsurgical hospital stay was 10.0 ± 2.3 days. Postoperative confirmation scanning was performed without moving the patients.

Conclusion

MR-guided laparoscopic microwave coagulation therapy is an effective treatment for hepatic tumors adjacent to other organs, as it allows for more accurate detection of lesions and for tumors to be treated safely while avoiding adjacent organs. It is less invasive than conventional procedures, because the MR real-time guidance enabled continuous monitoring throughout the procedure.

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Acknowledgments

The authors would like to thank Enago (www.enago.jp) for the English language review.

Conflict of interest

Koichiro Murakami and co-authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Biomedical Innovation Centre, Shiga University of Medical Science, Seta Tsukinowa-cho, Ōtsu, Shiga, 502-2121, Japan

    Koichiro Murakami & Tohru Tani

  2. Department of Surgery, Shiga University of Medical Science, Ōtsu, Japan

    Koichiro Murakami, Shigeyuki Naka, Hisanori Shiomi & Hiroya Akabori

  3. Department of Comprehensive Surgery, Shiga University of Medical Science, Ōtsu, Japan

    Yoshimasa Kurumi

  4. Department of Fundamental Nursing, Shiga University of Medical Science, Ōtsu, Japan

    Shigehiro Morikawa

Authors
  1. Koichiro Murakami
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  2. Shigeyuki Naka
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  3. Hisanori Shiomi
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  4. Hiroya Akabori
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  5. Yoshimasa Kurumi
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  6. Shigehiro Morikawa
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  7. Tohru Tani
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Correspondence to Koichiro Murakami.

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Murakami, K., Naka, S., Shiomi, H. et al. Initial experiences with MR Image-guided laparoscopic microwave coagulation therapy for hepatic tumors. Surg Today 45, 1173–1178 (2015). https://doi.org/10.1007/s00595-014-1042-x

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  • DOI: https://doi.org/10.1007/s00595-014-1042-x

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