eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2021
vol. 16
 
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abstract:
Original paper

Early experience with laparoscopic treatment of liver tumors using a separable cluster electrode with a no-touch technique

Hyun Pyo Hong
1
,
Jee Youn Lee
2
,
Mi Yeon Lee
3
,
Kyung Uk Jung
2
,
Byung Ik Kim
4
,
Byung Ho Son
2
,
Jun Ho Shin
2
,
Sung Ryol Lee
2

  1. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan School of Medicine, University, Seoul, Republic of Korea
  2. Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan School of Medicine, University, Seoul, Republic of Korea
  3. Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan School of Medicine, University, Seoul, Republic of Korea
  4. Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan School of Medicine, University, Seoul, Republic of Korea
Videosurgery Miniinv 2021; 16 (1): 76–82
DOI: https://doi.org/10.5114/wiitm.2020.95065
Online publish date: 2020/05/10
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Introduction
Radiofrequency ablation (RFA) is one of the best curative treatments for hepatocellular carcinoma in selected patients, and this procedure can be applied either percutaneously or laparoscopically. Laparoscopic RFA has the benefit of direct visual control of the RFA procedure. Cluster electrodes (Octopus RF electrodes) can create a common ablation zone.

Aim
Using these two methods (laparoscopic approach and no touch technique), this present study evaluated the technical and clinical outcomes of early experience with laparoscopic RFA and a no-touch technique.

Material and methods
Between November 2015 and November 2018, 21 patients underwent laparoscopic RFA for hepatocellular carcinoma with a no-touch technique using cluster electrodes. Laparoscopic RFA is recommended for patients with a contraindication for surgical resection, patients wants and a relative contraindication for conventional percutaneous RFA, such as lesions adjacent to the gastrointestinal tract, gallbladder, bile duct, or heart.

Results
In the 21 tumors, 2 were treated with a single electrode, 12 with 2 electrodes, and 7 tumors with 3 electrodes. The mean time of ablation per lesion was 20.43 ±8.77 min. There was no mortality, local tumor progression, delayed destructive biliary damage, or liver abscess at the follow-up computed tomography. No technical failures occurred.

Conclusions
Laparoscopic RFA can access lesions for which percutaneous RFA is contraindicated or risky. Cluster electrodes can create sufficient ablation zones without contact and can achieve a sufficient margin with a low complication rate and no tumor dissemination. Therefore, laparoscopic RFA with a no-touch technique might be a safe and feasible treatment for HCC tumor in selected patients.

keywords:

hepatocellular carcinoma,·radiofrequency ablation, laparoscopic radiofrequency ablation, cluster electrodes
  
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