Background and Study Aims: Radiofrequency (RF) thermal ablation has been applied almost
exclusively through the percutaneous approach under radiological/external ultrasound
guidance. We have embarked on a programme of laparoscopic ultrasound-guided RF ablation
of hepatic tumours in view of the potential advantages of this approach, i. e. reduced
heat sink effect, greater precision and improved assessment of the thermal ablative
zone.
Patients and Methods: RF thermal ablation using the Zomed International generator
and multielectrode probes in two patients with hepatoma arising on a background of
cirrhosis and in eight patients with multiple deposits from primary colorectal cancer.
Results: Total ablation was performed in two patients with hepatoma and 7/8 patients
with secondary deposits. Total ablation with a minimum of 0.5-cm margin was achieved
in 32 lesions. No complications were encountered postoperatively and all patients
were discharged within 2 days of the intervention. One patient in whom thermal ablation
was not completed has since died of progressive disease, eight appear to be free of
tumour (follow-up 6 - 20 months) but one patient has developed further secondary hepatic
deposits.
Conclusions: The initial experience with laparoscopic ultrasound-guided RF ablation
of hepatic tumours indicates its safety and therapeutic potential in patients with
inoperable hepatic tumours.
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FRCS A. Cuschieri
Dept. of Surgery
Ninewells Hospital and Medical School
University of Dundee
Dundee DD1 9SY
Scotland
Phone: + 44-1382-641795
Email: a.cuschieri@dundee.ac.uk
