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- W3200486589 abstract "Presenter: Omero Costa Filho MD, MSc | Hospital Militar de Área de Porto Alegre (HMAPA) Background: Hepatocellularcarcinoma (HCC)is a heterogeneous disease with many available treatment modalities. Transarterial chemoembolization (TACE) is a valuable treatment modality for HCC lesions. Some evidence seeks to evaluate the utility of additional ablative therapy in the management of patients with HCC who received an initial TACE procedure. Microwave ablation (MWA) and radiofrequency ablation (RFA) are considered to have equivalent efficacy, complication rates, local recurrence rates and survival rates. MWA has advantages over RFA in terms of ablation volume, temperature and operation time. Methods: This is a case report of first microwave ablation done by laparoscopy in Brazil after TACE procedure. Results: A 89 years old men, in follow up of renal lesion, had diagnosis of HCC of 2,5 cm in transition of 4b, 5 and 8 segments. He has history of hepatitis C treated, Child A, and alcohol consume irregular. Alfafetopretein (AFP) was 11,6 ng/ml. Inicial treatment proposed was TACE, because the HCC is to close to hilum and main portal vein and frailty reasons. After two sessions, AFP down to 2,7 ng/ml and CT scan showed no more wash out in the lesion. At MRI, identified a 1 cm residual tumor. After all and discussion at multidisciplinary team, we propose a MWA by laparoscopic.Two 12 mm trocars and one 5 mm trocar was used under 14-12 mmhm pneumoperitoneum. The MWA antenna (Solero Microwave Tissue Ablation - AngioDynamics, Latham, NY, EUA) were guided by intra-operative ultrasound (Toshiba/Canon, Japan) with care taken to allow for complete tumor treatment while preserving adequate distance between the microwave near-field and adjacent intra hepatic structures (portal pedicles, hepatic veins). One single application was done. Mesures of tumor was 25,9 mm x 13,3 mm and ablation final area was 33,8 mm x 26,4 mm. Procedure was uneventful and patient was discharged to home at same day. He was follow up at 3 and 6 months with MRI and AFP without recurrence or tumoral activity detected (RECIST - complete response) and normal hepatic and canalicular enzymes. Conclusion: Microwave ablation maybe considered for patients with hepatocellular carcinoma who have undergone transarterial chemoembolization and may be preferable for treating patients with periportal HCC." @default.
- W3200486589 created "2021-09-27" @default.
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- W3200486589 date "2021-01-01" @default.
- W3200486589 modified "2023-09-27" @default.
- W3200486589 title "First microwave ablation of hepatocarcinoma by laparoscopy in Brazil - A case report" @default.
- W3200486589 doi "https://doi.org/10.1016/j.hpb.2021.06.243" @default.
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