To investigate the application value of laparoscopic radiofrequency ablation (LRFA) in the treatment of complicated hepatocellular carcinoma (HCC).

Clinical data of 40 patients with complicated HCC undergoing LRFA in the First People's Hospital of Foshan between October 2010 and June 2012 were retrospectively analyzed. Most HCC lesions were located at special sites or the patients had a bleeding tendency. Among the patients, 32 were males and 8 were females, with the age ranging from 39 to 79 years old and the median of 57 years old. Imageological examination indicated that 22 patients were with single lesion and 18 were with multiple lesions. The median diameter of the lesions was 2.6(1.0-5.0) cm. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients underwent LRFA under the guide of laparoscopic ultrasound. Enhanced computed tomography (CT) was performed 1 month after surgery to check the tumor ablation, and enhanced CT or magnetic resonance imaging (MRI) was performed every 3 months after surgery to check the tumor recurrence.

LRFA was performed successfully on all the patients. After surgery, 6 cases developed moderate ascites and 3 developed pleural effusion. No bleeding, liver failure, bile duct injury or gastrointestinal tract damage was observed. The incidence of postoperative complications was 22% (9/40). No perioperative death was observed. The complete ablation rate of the tumors was 90% (36/40), and tumor recurrence was observed in 24 cases after surgery, including 2 of primary recurrence and 22 of ectopic recurrence. The 1-, 2- and 4-year tumor recurrence rate was respectively 35%, 50% and 60%.

For the patients with HCC at special sites or at high risk of bleeding, LRFA is safe and effective in the short and mid-term treatment. It is an important supplement to percutaneous radiofrequency ablation.