Clinical effect on microwave coagulo-necrotic therapy combined with laparoscopic splenectomy in treatment of primary hepatocellular carcinoma complicated by hypersplenism

Objective To investigate the feasibility and safety of microwave coagulo-necrotic therapy ( MCN) combined with laparoscopic splenectomy ( LS) in the treatment of primary hepatocellular carcinoma ( PHC) complicated by hypersplenism. Methods A retrospective analysis was performed for the clinical data of 22 PHC patients with hypersplenism who were admitted to Baoji Municipal People' s Hospital from January 2008 to December 2012 and underwent MCN combined with LS. Their clinical data were collected, and postoperative complications and survival were observed. The t-test was used for comparison of continuous data, and the Kaplan-Meier method was used to plot cumulative survival curves. Results In MCN therapy, 5 patients underwent thoracotomy, 15 underwent laparotomy, and 2 underwent laparoscopic surgery; in LS treatment, 17 underwent hand-assisted LS and 5 underwent simple LS. The mean time of operation was ( 303. 24 ±56. 02) min, the mean blood loss volume was ( 146. 92 ± 60. 72) ml, and the mean weight of the resected spleen was ( 670. 42 ± 204. 54) g. Of all patients, 6 ( 27. 27% ) experienced postoperative recurrence, 5 ( 22. 73% ) experienced portal vein thrombosis, and 2 ( 9. 09% ) experienced pleural effusion. There was a significant increase in platelet count at 1 month after surgery [ ( 15. 72 ± 5. 47) ×104/μl vs ( 4. 43 ±1. 03) ×104/μl, t = 6. 83, P < 0. 001]. The 1-, 3-, and 5-year overall survival rates after surgery were 90. 91% , 68. 18% , and 59. 09% , respectively, and the 1-, 3-, and 5-year disease-free survival rates were 59. 09% , 13. 64% , and 13. 64% , respectively.Conclusion MCN combined with LS is safe, effective, and feasible in the treatment of PHC complicated by hypersplenism.