Early Laparoscopic Radiofrequency Ablation for Spontaneous Rupture of Hepatocellular Carcinoma.

Aims: To evaluate the technical and clinical outcomes of early laparoscopic radiofrequency (RF) ablation for spontaneously ruptured hepatocellular carcinoma (HCC).

Methods: From April 2005 to July 2015, ten patients with spontaneously ruptured HCC treated by laparoscopic RF ablation in our hospital were included in the study. The post treatment outcomes were recorded and analyzed.

Results: The mean size of the 10 HCCs was 6.6 ± 2.2 cm (4.0-10.1 cm) in the maximal dimension. Procedures of laparoscopic RF ablation were performed successfully for all patients. Complete ablation was achieved in 60.0% patients (6/10). Four patients with incompletely ablated tumors received repeated RF ablation to achieve complete ablation. During clinical follow-up, 3 (30.0%) patients developed minor complications and no patient had peritoneal recurrence. As of March 2016 (with a mean follow-up of 32.9 months), 3 patients (30.0%) were alive and 7 (70.0%) died. Of the 10 patients, the 1- and 3-year survival rates were 90.0% and 70.0%, respectively.

Conclusion: Early laparoscopic RF ablation therapy is an effective treatment measure for spontaneously ruptured HCC in selected patients, which presents an advantage of achieving simultaneous hemostasis, tumor elimination, and rinsing of peritoneal cavity to minimize the risk of peritoneal metastasis.