Transpleurodiaphragmatic radiofrequency thermoablation of a liver metastasis

Abstract

Repeat hepatectomy, when feasible, is the standard treatment for isolated liver recurrences after hepatectomy for malignancies. But percutaneous radiofrequency (RF) thermoablation is less invasive than and almost as safe as repeat hepatectomy. The percutaneous approach may be contraindicated when the liver recurrence is too high, too large, too close to major vessels, or isoechogenic. Repeat laparotomy is generally performed in these situations, for hepatectomy or mixed hepatectomy and RF thermoablation, or RF thermoablation alone. We describe a very simple curative treatment of a large liver tumor recurrence after a difficult primary hepatectomy, based on RF thermoablation by a transpleuro-diaphragmatic approach.