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World J Gastroenterol. Apr 7, 2008; 14(13): 2037-2043
Published online Apr 7, 2008. doi: 10.3748/wjg.14.2037
A combination therapy of ethanol injection and radiofrequency ablation under general anesthesia for the treatment of hepatocellular carcinoma
Kazutaka Kurokohchi, Seishiro Watanabe, Hirohito Yoneyama, Akihiro Deguchi, Tsutomu Masaki, Takashi Himoto, Hisaaki Miyoshi, Hamdy Saad Mohammad, Akira Kitanaka, Tomohiko Taminato, Shigeki Kuriyama
Kazutaka Kurokohchi, Seishiro Watanabe, Hirohito Yoneyama, Akihiro Deguchi, Tsutomu Masaki, Takashi Himoto, Hisaaki Miyoshi, Hamdy Saad Mohammad, Shigeki Kuriyama, Department of Gastroenterology and Neurology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
Kazutaka Kurokohchi, Akira Kitanaka, Tomohiko Taminato, Department of Laboratory Medicine, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
Author contributions: Kurokohchi K designed research and wrote the paper; Kurokohchi K, Watanabe S, Yoneyama H, Deguchi A, Masaki T, Himoto T, Mohammad HS, and Kitanaka A performed research; Miyoshi H analyzed data; Taminato T and Kuriyama S supervised the whole study.
Correspondence to: Dr. Kazutaka Kurokohchi, Department of Gastroenterology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. kuroko@med.kagawa-u.ac.jp
Telephone: +81-87-8912156
Fax: +81-87-8912158
Received: July 31, 2007
Revised: February 13, 2008
Published online: April 7, 2008
Abstract

AIM: To summarize the effects of laparoscopic ethanol injection and radiofrequency ablation (L-EI-RFA), thoracoscopic (T-EI-RFA) and open-surgery assisted EI-RFA (O-EI-RFA) under general anesthesia for the treatment of hepatocellular carcinoma (HCC).

METHODS: Time-lag performance of RFA after ethanol injection (Time-lag PEI-RFA) was performed in all cases. The volume of coagulated necrosis and the applied energy for total and per unit volume coagulated necrosis were examined in the groups treated under general (group G) or local anesthesia (group L).

RESULTS: The results showed that the total applied energy and the applied energy per unit volume of whole and marginal, coagulated necrosis were significantly larger in group G than those in the group L, resulting in a larger volume of coagulated necrosis in the group G. The rate of local tumor recurrence within one year was extremely low in group G.

CONCLUSION: These results suggest that EI-RFA, under general anesthesia, may be effective for the treatment of HCC because a larger quantity of ethanol and energy could be applied during treatment under pain-free condition for the patients.

Keywords: Combination therapy; Ethanol injection; Radiofrequency ablation; General anesthesia, Local anesthesia