Treatment of portal vein tumor thrombus of hepatocellular carcinoma with percutaneous laser ablation / 中国微创外科杂志

ABSTRACT

Objective To evaluate the efficacy of percutaneous laser ablation in the management of portal vein tumor thrombus(PVTT)of hepatocellular carcinoma(HCC).Methods Under ultrasound guidance,a needle was percutaneously punctured into the portal vein,through the axial of the tumor thrombus,and until the proximal end.An optic fiber was inserted through the needle and repeated pulse laser ablation was given.Results Complications included 102 cases(94.4%)of pyrexia 1～3 d after treatment(37.5～39.5 ℃),84 cases(77.8%)of incisional pain,and 3 cases(2.8%)of upper gastrointestinal bleeding.There were three types of findings of PVTT in 53 cases surviving over 1 year①the tumor thrombus was atrophied and disappeared in 20 cases;②the thrombus was atrophied and the portal vein exhibited a honeycomb-like appearance in 18 cases;③the thrombus kept on growing and the portal vein was enlarged in diameter in 15 cases.Among 95 cases of totally occluded portal vein,color blood flow signals appeared in all of them on the first postoperative day.The signals could still be seen in 76 cases at 1 month after treatment,in 64 cases(out of 91 cases)at 3 months,in 52 cases(out of 71 cases)at 6 months,in 36 cases(out of 42 cases)at 1 year,in 10 cases(out of 14 cases)at 2 years,and in 2 cases(out of 2 cases)at 3 years.The 1-,2-,and 3-year survival rates were 55.56%,35.20%,and 20.30%,respectively.Conclusions Percutaneous laser ablation is a feasible novel option for the treatment of portal vein tumor thrombus of hepatocellular carcinoma.