Hepatectomy combined with microwave ablation of the spleen for treatment of hepatocellular carcinoma complicated with splenomegaly: A retrospective study

Han,Jian‑Bo; Kong,Feng‑Wei; Ding,Hai; Zhang,Yu‑Feng; Liu,Jun‑Mao; Wei,Qiang; Hu,Liang; Zhao,Liang; Xu,Chuan‑Jun; Yi,Yong‑Xiang

doi:10.3892/mco.2016.1111

Hepatectomy combined with microwave ablation of the spleen for treatment of hepatocellular carcinoma complicated with splenomegaly: A retrospective study

Authors:
- Jian‑Bo Han
- Feng‑Wei Kong
- Hai Ding
- Yu‑Feng Zhang
- Jun‑Mao Liu
- Qiang Wei
- Liang Hu
- Liang Zhao
- Chuan‑Jun Xu
- Yong‑Xiang Yi
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Affiliations: Department of Hepatobiliary Surgery, The Second Hospital of Nanjing, Affiliated to Southeast University, Nanjing, Jiangsu 210003, P.R. China, Department of General Surgery, Xuzhou Infectious Diseases Hospital, Xuzhou, Jiangsu 221004, P.R. China, Department of Interventional Ultrasound, The Second Hospital of Nanjing, Affiliated to Southeast University, Nanjing, Jiangsu 210003, P.R. China, Department of Medical Imaging, The Second Hospital of Nanjing, Affiliated to Southeast University, Nanjing, Jiangsu 210003, P.R. China
Published online on: December 14, 2016 https://doi.org/10.3892/mco.2016.1111
Pages: 204-208

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Abstract

The present retrospective study aimed to investigate the mid‑term safety and efficacy of hepatectomy combined with microwave ablation of the partial spleen for treatment of liver cancer complicated with hypersplenism. A retrospective analysis was performed on 23 patients who underwent hepatectomy combined with microwave ablation of the partial spleen for liver cancer, complicated with hypersplenism that was secondary to cirrhosis. The splenic and ablated volumes were calculated according to a contrast‑enhanced computed tomography scan prior to and 2 weeks after the operation. Complete blood count and liver function tests were examined prior to and following the surgery, and complications and changes in the blood tests were monitored for 6 months. Over this period of investigation, the splenic volume was reduced by a mean value of 34.0%. The levels of serum alanine aminotransferase and aspartate aminotransferase were increased on the first day after the operation (P<0.05), although they recovered to the normal level within 1 week (P<0.05). The total level of bilirubin increased slightly, along with moderately decreased levels of albumin and cholinesterase on the first day, although these changes were not significant compared with the baseline (P>0.05). The white blood cell count was persistently significantly higher compared with the baseline over the course of the 6 months (P>0.05). The platelet count did not increase significantly for the first week after the operation (P>0.05); however, it was revealed to be significantly increased 1 month after the surgery (P<0.05). No significant complications were occurred during the follow‑up period. In conclusion, hepatectomy combined with microwave ablation of the spleen was demonstrated to be a safe and effective procedure for patients with liver cancer and hypersplenism in the mid-term.

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1	Nanashima A, Abo T, Takeshita H, Yamasaki N, Sawai T and Nagayasu T: Safety of hepatectomy accompanying combined resection of other organs. Hepatogastroenterology. 59:1915–1920. 2012.PubMed/NCBI
2	Wang C, Li C, Wen TF, Yan LN, Li B, Liang GL and Li KW: Safety of synchronous hepatectomy and splenectomy for patients with hepatocellular carcinoma and hypersplenism. Hepatogastroenterology. 59:526–528. 2012.PubMed/NCBI
3	Ohno T, Furui J, Hashimoto T, Hirabaru M, Kohno M, Iwao A and Koyamatsu J: Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: Report of a case. Surg Today. 41:444–447. 2011. View Article : Google Scholar : PubMed/NCBI
4	Aiyama T, Kamiyama T, Nakanishi K, Yokoo H, Taniguchi M, Fukumori D, Tahara M, Kakisaka T, Kamachi H, Matsushita M and Todo S: A study of cirrhotic patients with hepatocellular carcinoma and huge splenomegaly who received treatment for hepatocellular carcinoma with concomitant splenectomy. Gan To Kagaku Ryoho. 37:2683–2686. 2010.(In Japanese). PubMed/NCBI
5	Ushitora Y, Tashiro H, Takahashi S, Amano H, Oshita A, Kobayashi T, Chayama K and Ohdan H: Splenectomy in chronic hepatic disorders: Portal vein thrombosis and improvement of liver function. Dig Surg. 28:9–14. 2011. View Article : Google Scholar : PubMed/NCBI
6	Cheng JW and Lv Y: New progress of non-surgical treatments for hepatocellular carcinoma. Med Oncol. 30:3812013. View Article : Google Scholar : PubMed/NCBI
7	Koconis KG, Singh H and Soares G: Partial splenic embolization in the treatment of patients with portal hypertension: A review of the English language literature. J Vasc Interv Radiol. 18:463–481. 2007. View Article : Google Scholar : PubMed/NCBI
8	Shina S, Aoyama H, Shiratori Y, Mutoh H, Kurita M, Ota S, Terano A and Sugimoto T: Ultrasound-guided percutaneous injection of ethanolamine oleate for hypersplenism. An experimental study in dogs. Invest Radiol. 25:651–657. 1990.PubMed/NCBI
9	Matsumoto T, Yamagami T, Terayama K, Kato T, Hirota T, Yoshimatsu R, Miura H, Ito H, Okanoue T and Nishimura T: Risk factors and clinical course of portal and/or splenic vein thrombosis after partial splenic embolization. Acta Radiol. 50:617–623. 2009. View Article : Google Scholar : PubMed/NCBI
10	Hayashi H, Beppu T, Okabe K, Masuda T, Okabe H and Baba H: Risk factors for complications after partial splenic embolization for liver cirrhosis. Br J Surg. 95:744–50. 2008. View Article : Google Scholar : PubMed/NCBI
11	Wang HY, Shih SC, Lin SC, Chang WS, Wang TE, Lin FJ and Yang FS: Partial splenic embolization: 12-month hematological effects and complications. Hepatogastroenterology. 55:1838–1842. 2008.PubMed/NCBI
12	Li Y, Cui L, Zhang W, Tian Y and Li M: Laparoscopic radiofrequency ablation for traumatic splenic rupture. J Surg Res. 185:711–716. 2013. View Article : Google Scholar : PubMed/NCBI
13	Feng K, Ma K, Liu Q, Wu Q, Dong J and Bie P: Randomized clinical trial of splenic radiofrequency ablation versus splenectomy for severe hypersplenism. Br J Surg. 98:354–361. 2011. View Article : Google Scholar : PubMed/NCBI
14	Liu Q, Ma K, He Z, Dong J, Hua X, Huang X and Qiao L: Radiofrequency ablation for hypersplenism in patients with liver cirrhosis: A pilot study. J Gastrointest Surg. 9:648–657. 2005. View Article : Google Scholar : PubMed/NCBI
15	Liang P, Gao Y, Zhang H, Yu X, Wang Y, Duan Y and Shi W: Microwave ablation in the spleen for treatment of secondary hypersplenism: A preliminary study. AJR Am J Roentgenol. 196:692–696. 2011. View Article : Google Scholar : PubMed/NCBI
16	Ishikawa T, Kubota T, Horigome R, Kimura N, Honda H, Iwanaga A, Seki K, Honma T and Yoshida T: Concurrent partial splenic embolization with transcatheter arterial chemoembolization for hepatocellular carcinoma can maintain hepatic functional reserve. Hepatol Res. 44:1056–1061. 2014. View Article : Google Scholar : PubMed/NCBI
17	Hidaka H, Kokubu S, Nakazawa T, Minamino T, Takada J, Tanaka Y, Okuwaki Y, Watanabe M, Shibuya A and Saigenji K: Therapeutic benefits of partial splenic embolization for thrombocytopenia in hepatocellular carcinoma patients treated with radiofrequency ablation. Hepatol Res. 39:772–778. 2009. View Article : Google Scholar : PubMed/NCBI
18	Harao M, Beppu T, Masuda T, Hayashi H, Okabe H, Okabe K, Imseung C, Komori H, Horino K and Baba H: The significance of combined treatment for hepatocellular carcinoma with partial splenic embolization and transcatheter arterial chemoembolization using IA call/lipiodol. Gan To Kagaku Ryoho. 35:2027–2079. 2008.(In Japanese). PubMed/NCBI
19	Huang JH, Gao F, Gu YK, Li WQ and Lu LW: Combined treatment of hepatocellular carcinoma with partial splenic embolization and transcatheter hepatic arterial chemoembolization. World J Gastroenterol. 13:6593–6597. 2007. View Article : Google Scholar : PubMed/NCBI
20	Shimizu T, Tajiri T, Yoshida H, Mamada Y, Taniai N, Kawano Y, Takahashi T, Arima Y, Aramaki T and Kumazaki T: Hand-assisted laparoscopic hepatectomy after partial splenic embolization. Surg Endosc. 17:16762003. View Article : Google Scholar : PubMed/NCBI
21	Wood BJ and Bates S: Radiofrequency thermal ablation of a splenic metastasis. J Vasc Interv Radiol. 12:261–263. 2001. View Article : Google Scholar : PubMed/NCBI
22	Liu QD, Ma KS, He ZP, Ding J, Hung XQ and Dong JH: Experimental study on the feasibility and safety of radiofrequency ablation for secondary splenomagely and hypersplenism. World J Gastroenterol. 9:813–817. 2003. View Article : Google Scholar : PubMed/NCBI
23	Nasr MM, Hassan AM, Elsebaie SB, Elsebae MA and Nosseir MM: Effect of splenectomy on liver regeneration and function following partial hepatectomy: Experimental study. J Egypt Soc Parasitol. 41:601–610. 2011.PubMed/NCBI
24	Arakawa Y, Shimada M, Utsunomya T, Imura S, Morine Y, Ikemoto T and Takasu C: Effects of splenectomy on hepatic gene expression profiles after massive hepatectomy in rats. J Gastroenterol Hepatol. 28:1669–1677. 2013.PubMed/NCBI
25	Kim J, Kim CJ, Ko IG, Joo SH and Ahn HJ: Splenectomy affects the balance between hepatic growth factor and transforming growth factor-β and its effect on liver regeneration is dependent on the amount of liver resection in rats. J Korean Surg Soc. 82:238–235. 2012. View Article : Google Scholar : PubMed/NCBI
26	Ren YS, Qian NS, Tang Y, Liao YH, Liu WH, Raut V, Tao KS and Dou KF: Beneficial effects of splenectomy on liver regeneration in a rat model of massive hepatectomy. Hepatobiliary Pancreat Dis Int. 11:60–65. 2012. View Article : Google Scholar : PubMed/NCBI
27	Arakawa Y, Shimada M, Uchiyama H, Ikegami T, Yoshizumi T, Imura S, Morine Y and Kanemura H: Beneficial effects of splenectomy on massive hepatectomy model in rats. Hepatol Res. 39:391–397. 2009. View Article : Google Scholar : PubMed/NCBI
28	Zipprich A, Steudel N, Behrmann C, Meiss F, Sziegoleit U, Fleig WE and Kleber G: Functional significance of hepatic arterial flow reserve in patients with cirrhosis. Hepatology. 37:385–392. 2003. View Article : Google Scholar : PubMed/NCBI
29	Eipel C, Abshagen K, Ritter J, Cantré D, Menger MD and Vollmar B: Splenectomy improves survival by increasing arterial blood supply in a rat model of reduced-size liver. Transpl Int. 23:998–1007. 2010. View Article : Google Scholar : PubMed/NCBI
30	Liu QD, Ma K, Song Y, Zhou N and He Z: Two-year follow-up of splenic radiofrequency ablation in patients with cirrhosis hypersplenism: Dose increased hepatic arterial flow induce liver regeneration? Surgery. 143:509–518. 2008. View Article : Google Scholar : PubMed/NCBI
31	Goldberg SN, Solbiati L, Halpern EF and Gazelle GS: Variables affecting proper system grounding for radiofrequency ablation in an animal model. J Vasc Interv Radiol. 11:1069–1075. 2000. View Article : Google Scholar : PubMed/NCBI
32	Ushitora Y, Tashiro H, Takahashi S, Amano H, Oshita A, Kobayashi T, Chayama K and Ohdan H: Splenectomy in chronic hepatic disorders: Portal vein thrombosis and improvement of liver function. Dig Surg. 28:9–14. 2011. View Article : Google Scholar : PubMed/NCBI