Ethanol injection therapy for small hepatocellular carcinomas located beneath a large vessel using a curved percutaneous ethanol injection therapy needle

Watanabe,Seishiro; Morishita,Asahiro; Deguchi,Akihiro; Nakai,Seiji; Sakamoto,Teppei; Fujita,Koji; Maeda,Emiko; Nomura,Takako; Tani,Joji; Miyoshi,Hisaaki; Yoneyama,Hirohito; Fujiwara,Shintaro; Kobara,Hideki; Mori,Hirohito; Himoto,Takashi; Masaki,Tsutomu

doi:10.3892/ol.2014.2053

Ethanol injection therapy for small hepatocellular carcinomas located beneath a large vessel using a curved percutaneous ethanol injection therapy needle

Authors:
- Seishiro Watanabe
- Asahiro Morishita
- Akihiro Deguchi
- Seiji Nakai
- Teppei Sakamoto
- Koji Fujita
- Emiko Maeda
- Takako Nomura
- Joji Tani
- Hisaaki Miyoshi
- Hirohito Yoneyama
- Shintaro Fujiwara
- Hideki Kobara
- Hirohito Mori
- Takashi Himoto
- Tsutomu Masaki
View Affiliations

Affiliations: Department of Internal Medicine, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa 760-8557, Japan, Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Miki‑cho, Kida‑gun, Kagawa 761-0793, Japan, Department of Integrated Medicine, Kagawa University School of Medicine, Miki‑cho, Kida‑gun, Kagawa 761-0793, Japan
Published online on: April 9, 2014 https://doi.org/10.3892/ol.2014.2053
Pages: 1831-1834

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Percutaneous ethanol injection therapy (PEIT) has been administered as a safe therapeutic modality for patients with small hepatocellular carcinoma (HCC). Due to the nature of the straight approaching line of a PEIT or radiofrequency ablation needle, penetrating the vessels that are interposed between the dermal insertion point and the nodule is unavoidable. A device with an overcoat needle and coaxial curved PEIT needle was created that facilitated a detour around interposing large vessels in order to avoid unnecessary harmful effects that result from the PEIT procedure. Two cases of HCC located adjacent to a neighboring large vessel were treated with a curved PEIT needle. The curved PEIT needle, which is connected to an outer needle, enabled deviation around the interposing vessels and successful connection with the HCC. Careful use of the curved line of the PEIT needle enabled the safe and successful performance of the PEIT without any requirement for specific training. This hand‑assisted technique may be an applicable treatment for small HCC located beneath large vessels as a direct therapeutic method using ultrasound guidance.

View Figures

View References

1	Shiina S, Hata Y, Niwa Y, et al: Multiple-needle insertion method in percutaneous ethanol injection therapy for liver neoplasms. Gastroenterol Jpn. 26:47–50. 1991.PubMed/NCBI
2	Tateishi R, Shiina S, Teratani T, et al: Percutaneous radiofrequency ablation for hepatocellular carcinoma. An analysis of 1000 cases. Cancer. 103:1201–1209. 2005.PubMed/NCBI
3	Kuo YH, Lu SN, Chen CL, et al: Hepatocellular carcinoma surveillance and appropriate treatment options improve survival for patients with liver cirrhosis. Eur J Cancer. 46:744–751. 2010. View Article : Google Scholar
4	Couinaud C: Liver lobes and segments: notes on the anatomical architecture and surgery of the liver. Presse Med. 62:709–712. 1954.(In French).
5	Kurokohchi K, Masaki T, Miyauchi Y, et al: Percutaneous ethanol and lipiodol injection therapy for hepatocellular carcinoma. Int J Oncol. 24:381–387. 2004.PubMed/NCBI
6	Jinno K, Moriwaki S, Tanada M, et al: Clinicopathological study on combination therapy consisting of arterial infusion of lipiodol-dissolved SMANCS and transcatheter arterial embolization for hepatocellular carcinoma. Cancer Chemother Pharmacol. 31(Suppl): S7–S12. 1992. View Article : Google Scholar
7	Massarweh NN, Park JO, Farjah F, et al: Trends in the utilization and impact of radiofrequency ablation for hepatocellular carcinoma. J Am Coll Surg. 210:441–448. 2010. View Article : Google Scholar : PubMed/NCBI
8	Hasegawa S, Yamasaki N, Hiwaki T, et al: Factors that predict intrahepatic recurrence of hepatocellular carcinoma in 81 patients initially treated by percutaneous ethanol injection. Cancer. 86:1682–1690. 1999. View Article : Google Scholar
9	Rustemović N, Vucelić B, Opacić M, et al: Palliative treatment of hepatocellular carcinoma with percutaneous ethanol injection using tumor’s feeding artery occlusion under the ultrasonic color Doppler guidance. Coll Antropol. 28:781–791. 2004.
10	Arimura E, Kotoh K, Nakamuta M, et al: Local recurrence is an important prognostic factor of hepatocellular carcinoma. World J Gastroenterol. 11:5601–5606. 2005.PubMed/NCBI
11	Orlando A, Leandro G, Olivo M, Andriulli A and Cottone M: Radiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled trials. Am J Gastroenterol. 104:514–524. 2009. View Article : Google Scholar
12	Ebara M, Ohto M, Sugiura N, et al: Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Study of 95 patients. J Gastroenterol Hepatol. 5:616–626. 1990. View Article : Google Scholar : PubMed/NCBI
13	Khan KN, Yatsuhashi H, Yamasaki K, et al: Prospective analysis of risk factors for early intrahepatic recurrence of hepatocellular carcinoma following ethanol injection. J Hepatol. 32:269–278. 2000. View Article : Google Scholar : PubMed/NCBI
14	Huang GT, Lee PH, Tsang YM, et al: Percutaneous ethanol injection versus surgical resection for the treatment of small hepatocellular carcinoma. Ann Surg. 242:36–42. 2005. View Article : Google Scholar : PubMed/NCBI
15	Livraghi T: Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis. Hepatogastroenterology. 48:20–24. 2001.PubMed/NCBI
16	Lin SM and Lin DY: Percutaneous local ablation therapy in small hepatocellular carcinoma. Chang Gung Med J. 26:308–314. 2003.PubMed/NCBI
17	Pompili M, Rapaccini GL, Covino M, et al: Prognostic factors for survival in patients with compensated cirrhosis and small hepatocellular carcinoma after percutaneous ethanol injection therapy. Cancer. 92:126–135. 2001. View Article : Google Scholar
18	Livraghi T, Bolondi L, Lazzaroni S, et al: Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis. A study on 207 patients. Cancer. 69:925–929. 1992. View Article : Google Scholar : PubMed/NCBI
19	Shiina S, Teratani T, Obi S, et al: Percutaneous ethanol injection therapy for liver tumors. Eur J Ultrasound. 13:95–106. 2001. View Article : Google Scholar : PubMed/NCBI
20	Arii S, Yamaoka Y, Futagawa S, et al: Results of surgical and nonsurgical treatment for small-sized hepatocellular carcinomas: a retrospective and nationwide survey in Japan. The Liver Cancer Study Group of Japan. Hepatology. 32:1224–1229. 2000. View Article : Google Scholar
21	Seki T, Wakabayashi M, Nakagawa T, et al: Hepatic infarction following percutaneous ethanol injection therapy for hepatocellular carcinoma. Eur J Gastroenterol Hepatol. 10:915–918. 1998. View Article : Google Scholar : PubMed/NCBI
22	Castroagudin JF, Delgado M, Villanueva A, et al: Safety of percutaneous ethanol injection as neoadjuvant therapy for hepatocellular carcinoma in waiting list liver transplant candidates. Transplant Proc. 37:3871–3873. 2005. View Article : Google Scholar
23	Koda M, Okamoto K, Miyoshi Y and Kawasaki H: Hepatic vascular and bile duct injury after ethanol injection therapy for hepatocellular carcinoma. Gastrointest Radiol. 17:167–169. 1992. View Article : Google Scholar : PubMed/NCBI
24	Zuo CJ, Wang PJ, Shao CW, et al: CT-guided percutaneous ethanol injection with disposable curved needle for treatment of malignant liver neoplasms and their metastases in retroperitoneal lymph nodes. World J Gastroenterol. 10:58–61. 2004.