Laparoscopic repair of diaphragmatic hernia after radiofrequency ablation for hepatocellular carcinoma: Case report

Ushijima, Hokuto; Hida, Jin‐ichi; Yane, Yoshinori; Katô, Hiroaki; Kawamura, Junichiro

doi:10.1016/j.ijscr.2021.105728

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…Recently, laparoscopic surgery for treating DH after RFA was reported [3]. However, our review of the literature in PubMed, using "diaphragmatic hernia" and "radiofrequency ablation" as keywords, revealed that the laparoscopic approach was used in only three cases [2,3,12], and there was no report of the use of the laparoscopic approach for emergency treatment of a similar case of strangulated DH occurring after RFA.…”

Section: Discussionmentioning

confidence: 99%

“…Accurate diagnosis of DH is difficult owing to its nonspecific symptoms and is occasionally delayed [1]. Unlike laparoscopic surgery, open surgery is a widely accepted surgical approach for DH [2]. However, a recent report showed that the laparoscopic approach has both diagnostic and therapeutic abilities [3]; moreover, laparoscopic surgery is less invasive than open surgery.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic surgery for strangulated diaphragmatic hernia after radiofrequency ablation for hepatocellular carcinoma: a case report

Kimura

Ishioka

Kamiyama³

et al. 2021

surg case rep

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Background Percutaneous radiofrequency ablation (RFA) is an effective treatment for hepatocellular carcinoma (HCC), but delayed thermal damage can cause diaphragmatic hernia (DH). Surgery is recommended for DH, and open surgery is widely accepted. This report presents a case of laparoscopic surgery for strangulated DH that occurred after RFA. Case presentation An 80-year-old woman with a history of hepatitis C-induced liver cirrhosis and HCC was admitted to our institution owing to sudden-onset intense epigastric pain. Twenty-two months earlier, she received RFA treatment for HCC located in segment 6/7. Contrast-enhanced computed tomography revealed herniation of the small intestine into the thoracic cavity, with mesenteric fat haziness. Emergency laparoscopic surgery was performed, and the patient was diagnosed with strangulated DH associated with the prior RFA. The defect was closed using absorbable sutures, and the ischaemic small intestine was resected via mini-laparotomy. The patient was discharged on the 10th postoperative day without complications, and no evidence of DH recurrence 15 months after surgery was noted. Conclusions Laparoscopic surgery seems useful and feasible for strangulated DH.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery for strangulated diaphragmatic hernia after radiofrequency ablation for hepatocellular carcinoma: a case report

Kimura

Ishioka

Kamiyama³

et al. 2021

surg case rep

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“…Twenty cases of diaphragmatic hernia due to RFA have been reported in English including our case. The background of the patients and the details of RFA are given in Table 1 [ 8 - 21 ]. The details of diaphragmatic hernia and the treatment are presented in Table 2 .…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic repair of diaphragmatic hernia associating with radiofrequency ablation for hepatocellular carcinoma: A case report

Tsunoda¹,

Nishi²,

Ito³

et al. 2022

WJCC

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BACKGROUND Radiofrequency ablation (RFA) is an effective treatment for early-stage hepatocellular carcinoma (HCC). Although RFA is a relatively safe technique compared with surgery, several complications have been reported to be following/accompanying this treatment. Delayed diaphragmatic hernia caused by RFA is rare; however, the best surgical approach for its treatment is uncertain. We present a case of laparoscopic repair of diaphragmatic hernia due to RFA. CASE SUMMARY An 80-year-old woman with segment VIII HCC was treated twice in 5 years with RFA; 28 mo after the second RFA, the patient complained of right hypochondriac pain. Computed tomography revealed that the small intestine was incarcerated in the right thorax. The patient was diagnosed with diaphragmatic hernia and underwent laparoscopic repair by non-absorbable running sutures. The patient’s postoperative course was favorable, and the patient was discharged on postoperative day 12. The diaphragmatic hernia has not recurred 24 mo after surgery. CONCLUSION Laparoscopic treatment of iatrogenic diaphragmatic hernia is effective and minimally invasive.

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“…The incidence was less than 0.1% without the application of artificial effusion [10]. Only 13 cases of RFA related DH were reported in English literature (Table 1) [11][12][13][14][15]. All 13 DHs were late-onset, ranging from 7 to 96 months after RFA.…”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic Disruption Ahead of Herniation Following Hepatic Radiofrequency Ablation

T¹,

H²,

H³

et al. 2021

JJGH

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A 48-year-old man with HBV-related cirrhosis was found to have three small hepatocellular carcinomas (HCC) in segment 5, 6 and 8 with a clinical stage of T2N0M0/BCLC stage A. He was treated with percutaneous radiofrequency ablation (RFA) with the aid of artificial pleural effusion to prevent thermal lung injury. However, a delayed diaphragmatic hernia with colon incarceration occurred 11 months later. Diaphragmatic disruption was noted retrospectively 4 months ahead of herniation at the previous image study. It is recommended to handle carefully HCC with RFA at the unfavorable location. Early detection of diaphragmatic injury could be repaired by minimally invasive surgery.

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Laparoscopic repair of diaphragmatic hernia after radiofrequency ablation for hepatocellular carcinoma: Case report

Cited by 5 publications

References 18 publications

Laparoscopic surgery for strangulated diaphragmatic hernia after radiofrequency ablation for hepatocellular carcinoma: a case report

Laparoscopic surgery for strangulated diaphragmatic hernia after radiofrequency ablation for hepatocellular carcinoma: a case report

Laparoscopic repair of diaphragmatic hernia associating with radiofrequency ablation for hepatocellular carcinoma: A case report

Diaphragmatic Disruption Ahead of Herniation Following Hepatic Radiofrequency Ablation

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