Intraoperative radiofrequency ablation and distilled water peritoneal lavage for spontaneously ruptured hepatocellular carcinoma

Bong Jun Kwak; Joonseon Park; Yong Kyong Kwon; Jung Hyun Kwon; Young Chul Yoon

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저자정보: Bong Jun Kwak (The Catholic University of Korea) Joonseon Park (The Catholic University of Korea) Yong Kyong Kwon (University of Southern California) Jung Hyun Kwon (The Catholic University of Korea) Young Chul Yoon (The Catholic University of Korea)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.6

발행연도: 2019.12

수록면: 291 - 295 (5page)

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Purpose: Spontaneously ruptured hepatocellular carcinoma (srHCC) is known to be a life-threatening complication with poor prognosis. Although there are various treatment modalities, there is no definite treatment guideline. The purpose of this study was to review the surgical outcome and prognosis of srHCC treated with intraoperative radiofrequency ablation (RFA) and distilled water peritoneal lavage (DWPL).
Methods: From March 2012 to October 2018, 9 patients with srHCC who underwent emergent surgery were reviewed. After hematoma removal, intraoperative RFA and DWPL were applied to all patients. Hepatectomy was performed if necessary. Patients with multiple tumors, distant metastasis, and vascular tumor involvement in radiologic imaging were excluded.
Results: Six of 9 patients with diameters less than 7 cm were able to obtain hemostasis using RFA alone (RFA group). However, 3 patients with a tumor size of more than 10 cm underwent liver resection because they could not obtain hemostasis with RFA (hepatectomy only group). The RFA group had shorter operation time (148.3 ± 31.7 minutes vs. 251.7 ± 20.2 minutes, P < 0.05) and less red blood cell transfusion (5.8 ± 2.5 packs vs. 24.0 ± 11.5 packs, P < 0.05) than the hepatectomy only group. There was no peritoneal metastasis at long-term follow-up in the RFA group. Five-year recurrence-free survival rate was 0% in both groups. However, 5-year overall survival rate was better in the RFA group (83.3% vs. 0%, P < 0.05).
Conclusion: Intraoperative RFA and DWPL are easy to perform and theoretically the best methods for managing relatively small srHCC.

#Hepatocellular carcinoma #Peritoneal lavage #Prognosis #Radiofrequency ablation #Rupture

참고문헌 (18)

참고문헌 신청

Lai EC / 2006 / Spontaneous rupture of hepatocellular carcinoma : a systematic review / Arch Surg 141:191~198

Ng KK / 2003 / Radiofrequency ablation as a salvage procedure for ruptured hepatocellular carcinoma / Hepatogastroenterology 50:1641~1643

Fuchizaki U / 2004 / Radiofrequency ablation for life-threatening ruptured hepatocellular carcinoma / J Hepatol 40:354~355

Sun WB / 2009 / Repeated radiofrequency ablation as both salvage solution and curative treatment for spontaneous rupture of giant medial lobe hepatocellular carcinoma / Chin Med J(Engl) 122:2067~2070

Chang YM / 2013 / Distilled water peritoneal lavage in patients with rupture hepatocellular carcinoma / Hepatogastroenterology 60:140~143

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