Microwave Coagulation Therapy as Minimally Invasive Surgery for Hepatocellular Carcinoma

Tsuneo Tanaka, Naoki Yamanaka, Wataru Tanaka, Junichi Yamanaka, Tatsuya Ando, Chiaki Yasui, Nobukazu Kuroda, Masafumi Takata, Shigeto Maeda, Kazuyuki Matsushita, Eizo Okamoto

First Department of Surgery, Hyogo College of Medicine

The aim of this study was to investigate whether microwave coagulation therapy (MCT) could be adopted as a treatment option with minimal invasiveness for hepatocellular carcinoma (HCC). Thirty-two patients had undergone endoscopic or open MCT for HCC from June 1992 to June 1997. Preoperative liver function, postoperative complications and prognosis of MCT patients were compared with those of 34 patients who underwent wedge resection. Postoperative mortality was seen in one case in each groups. Incidence of postoperative complication of MCT was less than that of wedge resection. The actual and disease-free 5-year survival rates were identical in the patients who received MCT and those who had wedge resection. MCT is a possible choice of treatment for HCC with severe liver cirrhosis. However, local recurrence due to incomplete coagulation occurred in 2 patients after endoscopic MCT. During the coagulation procedure, the coagulated area rapidly becomes indistinct due to generation of micro bubbles. Accurate mapping of coagulation guided by intraoperative ultrasonography before coagulation is the most important point for MCT.

Key words
minimally invasive surgery, hepatocellular carcinoma, microwave coagulation therapy

Reprint requests
Tsuneo Tanaka First Department of Surgery, Hyogo College of Medicine
1-1 Mukogawa-cho, Nishinomiya, 663-8131 JAPAN

Accepted
December 3, 1997

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