Behandeling van patiënten met irresectabele tumoren in de lever door middel van percutane interstitiële lasercoagulatie tijdens onderbreking van de bloedstroom naar de lever

To evaluate, in patients with hepatocellular carcinoma or colorectal carcinoma disseminated to the liver, treatment with interstitial laser coagulation (ILC) during tempo-rary occlusion of vascular inflow in the liver: feasibility, complications and initial tumour response.

Design

Prospective, descriptive.

Methods

Patients were included if their tumours were surgically irresectable and smaller than 4 cm in diameter and did not exceed a number of 3. ILC was performed under general anaesthesia, basically via a percutaneous approach. Vascular inflow was occluded during laser treatment. Twenty-four hours after ILC a triphasic spiral CT was performed to assess the result of the treatment.

Results

In 10 patients 14 hepatic tumours were lasered in 12 treatment sessions (10 percutaneous and 2 at laparotomy). After 5 treatment sessions, complications were observed of which pain at the insertion site of the catheters was the most frequent. For 6 out of the 10 patients with percutaneous procedures, discharge was within 24 hours after ILC. Nine out of the 14 tumours (65) were completely coagulated.

Conclusion

ILC with vascular inflow occlusion is a safe and feasible technique that can be performed during a short hospital stay. Initial tumour response is 65 and these results justify determination of duration of response in a larger group of patients.