Two Cases of Recurrent Hepatocellular Carcinomas after Hepatectomy -Treated with Microwave Coagulo-necrotic Therapy by a Transthoracic Approach

Ken Ishimura, Setsuo Okada, Hisao Wakabayashi, Takashi Maeba, Hajime Maeta

First Department of Surgery, Kagawa Medical School

We performed microwave coagulonecrotic therapy (MCT) by transthoratic approach in two cases of recurrent hepatocellular carcinoma after hepatectomy, and obtained good postoperative results. Case 1 was a 74-year-old man who had undergone hepatic resection twice. Massive bleeding was encountered during adhesiotomy in the second operation, and he was found to have recurrence again in S7. Case 2, a 62-year-old man, showed tumor recurrence in S8 of the liver after the partial resection of S4. In both cases the recurrent tumor was solitary and located near the surface of the liver under the diaphragma. Liver function did not permit conventional hepatic resection. Therefore, MCT by a transthoracic approach was chosen for the treatment of these tumors. In case 1, MCT was performed transdiaphragmatically, and in case 2, a coagulation needle was inserted after opening the diaphragma. In each case the blood loss was minimal and the postoperative course was satisfactory. The effective destruction of the tumor was ascertained by postoperative CT examination. This approach was considered to be an effective and less invasive surgical intervention for cases of recurrent hepatocellular carcinoma after hepatic resection.

Key words
recurrence hepatocellular carcinoma, microwave coagulonecrotic therapy, transthoracic approach

Reprint requests
Ken Ishimura First Department of Surgery, Kagawa Medical School
1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa,761-07 JAPAN

Accepted
December 6, 1995

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