Application of ultrasound-guided microwave ablation in the laparoscopic liver resection

Abstract

Objective To discuss the safety and efficacy of ultrasound-guided microwave ablation in the laparoscopic hepatectomy. Methods Four patients underwent laparoscopic hepatectomy using microwave ablation guided by ultrasound from September 2011 to September 2012 in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University were enrolled in this retrospective study. There were 3 males and 1 female with age ranging from 26 to 49 years old and a median age of 41 years old. There were 2 cases with hepatocellular carcinoma (HCC), 1 case with hepatic hemangioma and 1 case with hepatic focal nodular hyperplasia. The informed consents of all patients were obtained and the ethical committee approval was received. All the 4 patients underwent laparoscopic hepatectomy, intraoperative ultrasound guided microwave ablation and focal lesions resection after the liver tissue was coagulated and stopped bleeding. Intraoperative and postoperative condition of the patients, amount of intraoperative bleeding, operation time, postoperative hospital stay, complications and curative effect were observed and recorded. Results All the operations were successfully performed without any conversion to open laparotomy. The median amount of intraoperative bleeding was 90(50-120) ml, the operation time was 183(145-220) min, the postoperative hospital stay was 9(8-10) d. All patients recovered well after the operation and no complications such as abdominal bleeding and bile leakage were observed. The cutting edges of liver cancer of these 2 cases were negative. The postoperative follow-up time of these 2 cases were 6, 11 months respectively and no tumor recurrence and metastasis were observed. Conclusions Laparoscopic liver resection using microwave ablation guided by intraoperative ultrasound can effectively control the bleeding of resected liver and is a safe and effective minimally invasive technique. Key words: Hepatectomy; Laparoscope; Ultrasonography; Ablation techniques; Microwave