Indication and Technique of Surgical Treatment for Hepatocellular Carcinoma with Special Reference to Microwave Coagulation Therapy

Naoki Yamanaka

First Department of Surgery, Hyogo College of Medicine

The present study reports the usefulness of microwave coagulation therapy (MCT) as a new option in the treatment of hepatocellular carcinoma. Twenty-three patients were treated using a microwave monopolar electrode (output 100 watts), from July 1992 to the end of 1994 under open (n=15) or laparoscopic control (n=8). The tumors, superficially located and ranging from 1.3 to 6.5 cm in size, were coagulated from the tumor margin toward its center for a total radiation period of 28 ± 9.6 minutes. Postoperative complications were minimal, and the liver chemistries (leaking enzymes, bilirubin, albumin, prothrombin time) returned to the preoperative values within 7 days in most patients. Regular diet was started within a few postoperative days. Follow-up imaging (dynamic CT scan, angiography) suggested complete necrosis. In conclusion, the advantages of MCT include negligible blood loss, technical safety, early recovery, and strong necrotic effect. MCT can be a useful treatment option for hepatocellular carcinoma with severe liver cirrhosis, together with hepatectomy, embolization and ethanol injection.

Key words
microwave coagulation therapy, hepatocellular carcinoma, laparoscopic surgery

Reprint requests
Naoki Yamanaka First Department of Surgery, Hyogo College of Medicine
1-1 Mukogawacho, Nishinomiya, 633 JAPAN

Accepted
June 14, 1995

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