الفهرس 
INTRODUCTION
Extra hepatic metastases of HCCOnly 14 pages are availabe for public view
 |  | from | 130 |  |  |
| | | from | 130 | | |
Abstract
Because unresectable HCC is a great problem, much enthusiasm has been developed in the use of RFA for patients with this malignant condition. from a practical point of view, care of patient selection, meticulous RFA techniques, and close monitoring of tumour recurrence with prompt treatment if applicable are necessary to ensure a better outcome for patients undergoing RFA. It is indicated for unresectable HCC as a result of either advanced tumour stage or poor liver function; however, large tumour size poses a great challenge for clinicians who adopt this local ablation technique. Concise monitoring of the whole ablation process by radiological techniques is mandatory for this purpose, ultrasonography and CT scan have been widely adopted, but the formation of micro bubbles within the ablation area might obscure the view of these imaging studies, making the detection of any residual tumour difficult. New imaging techniques using contrast-enhanced Doppler sonography and CT angiography have been developed to evaluate the real-time therapeutic effect of RFA so that any residual tumour can be anticipated by additional ablation. The risks of RFA should not be underestimated as various risk factors have been identified to account for the complications and local failure of RFA. Clinicians should be cautious in applying this local ablation treatment to patients, and liberal use of RFA for liver tumours should be avoided instead, careful patient selection and meticulous RFA techniques need to be emphasized in clinical practice. The aim of the work was to evaluate the role of laparoscopic RFA in treatment of localized HCC in patients not candidate for hepatic resection.