Initial experience with laparoscopic ultrasound-guided radiofrequency thermal ablation of hepatic tumours

Abstract

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.