Thoracoscopic microwave coagulation therapy for hepatocellular carcinoma at the dome of the liver : three case reports

Percutaneous microwave coagulation therapy (PMCT) is an effective treatment for small hepatocellular carcinoma (HCC) even in the patients with low hepatic functional reserve. Due to intervention of lung, regular PMCT using ultrasonography is anatomically rather difficult to small HCC at the dome of the liver (segment VII or VIII). In the present study, thoracoscopic MCT (TMCT) was performed on the three cases with HCC, which occured at the dome of the liver.The case 1 was a 60-year-old man showing liver cirrhosis (LC) with HCC (1cm) at S8. The case 2 was a 71-year old man having LC with recurrent HCCs at S4/8 (1.7cm) and S6 (1.5cm) after lateral segmentectomy. The cases 3 was 51-year-old man with recurrent HCC at S8 (1.4cm) after posterior segmentectomy. The cases 1 was treated by TMCT. The cases 2 and 3 were treated by TMCT with supportive small thoracotomy. All the patients showed efficient coagulation effect. No complication was observed.We concluded that thoracoscopic MCT is an effective method.