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Outcome of Laparoscopic Assisted Percutaneous Microwave Ablation for Exophytic Versus Non-exophytic Hepatocellular Carcinoma

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Abstract

Background

Hepatocellular carcinoma (HCC) is one of the most common malignancies and is the third cause of cancer-related death worldwide. Surgery is the optimal treatment for early HCC; however, the majority of cases are not suitable for curative resection at the time of diagnosis. Surgical resection difficulties may be related to size, site, number of tumors, extrahepatic involvement, and patient general condition. Exophytic tumors were considered as relative contraindication for thermal ablation because of the risk of incomplete ablation or major complications as hemorrhage and seeding. Aim of this study: to evaluate the safety and efficacy of microwave ablation (MWA) of exophytic HCC in comparison with non-exophytic HCC.

Methods

Prospective comparative study carried on 30 patients having 30 exophytic (six of those patients had another non-exophytic lesion) and 32 patients having 44 non-exophytic HCC lesions (22 had single lesion, 8 patients had 2 lesions, and 2 patients had 3 lesions) within Milan criteria. All patients were child A or B, they were subjected to full clinical assessment, laboratory investigations, and radiological investigations. Laparoscopic assisted percutaneous MWA was the procedure of choice in our study for all patients either having exophytic or non-exophytic lesions using no-touch wedge technique for exophytic lesions and direct puncture for non-exophytic lesions.

Results

Technical success was 100% in both groups, all lesions were completely ablated as confirmed by LIOUS. There were no major complications or perioperative mortality and low incidence of local tumor progression in both exophytic and non-exophytic groups.

Conclusion

Laparoscopic assisted MWA of exophytic HCC is safe and effective with comparable results to non-exophytic HCC. Exophytic HCC is not contraindication for MWA with proper technique selection.

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Authors and Affiliations

  1. Surgical Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt

    Mohamed M. Mogahed

  2. Radiodiagnosis Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

    Ashraf Anas Zytoon

  3. Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt

    Basem Eysa & Mohamed Manaa

  4. Radiology Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt

    Wessam Abdellatif

Authors
  1. Mohamed M. Mogahed
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  2. Ashraf Anas Zytoon
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  3. Basem Eysa
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  4. Mohamed Manaa
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  5. Wessam Abdellatif
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Contributions

Guarantor of integrity of the entire study: all authors.

Study concepts and design: all authors.

Literature research: all authors.

Clinical studies: all authors.

Data analysis: all authors.

Statistical analysis: all authors.

Manuscript preparation: all authors.

Manuscript editing: all authors.

Corresponding author

Correspondence to Ashraf Anas Zytoon.

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The authors declare that they have no conflict of interest.

Ethics Approval and Consent to Participate

This study was approved by our Institutional Review Board (IRB). Informed written consent was obtained from the patients.

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Institution ethical approval obtained.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mogahed, M.M., Zytoon, A.A., Eysa, B. et al. Outcome of Laparoscopic Assisted Percutaneous Microwave Ablation for Exophytic Versus Non-exophytic Hepatocellular Carcinoma. J Gastrointest Canc 52, 892–898 (2021). https://doi.org/10.1007/s12029-020-00477-x

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  • DOI: https://doi.org/10.1007/s12029-020-00477-x

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