Transcatheter Arterial Enbolization (TAE) has been widely used to manage the patients with primary hepatocellular carcinoma (HCC) or metastatic tumors of the liver. It has been performed only at well equipped large hospitals, therefore most of
those
patients cold not have chances to be managed.
Without the aid of angiography, authors performed transarterial Chemo-lipiodolizations through surgically implanted ports in 6 patients who had HCC or metastatic tumors of the liver. Adjunctve transportal Lipiodol chemoembolizations were also
performed
in 2 advanced rectal cancer patients who showed no evidence of liver metastases. According to the purposes, 4 palliative lipiodolization for unresectable liver lesions and 4 adjunctive lipiodolization along the principles of multimodality therapy
were
performed.
Postoperatively, there were not only catheter related complications, such as misperfusion to the spleen and partial perfusion of the liver, but also chemoembolization related complications, such as gastroduodenal erosion, liver failure, liver
necrosis,
and spleen infarction. On serial post-lipiodolization CT scans. at least 50 per cent reduction of tumor size was noted in the 4 cases with unresectable tumors in the liver.
The authors consider that correct surgical catherization and port implantation in the time of operation, that is required for primary malignant lesions or other intra-abdominal problems than unresectable liver tumor itself, 1) could alleviate the
risk
of repeated catheterization. 2) could afford another effective way of management as TAE does, 3) could afford more chances to treat much more numbers of patients and to overcome the limitations of TAE, and 4) the time intervals longer than 2
months
of
repeated Lipiodol chemo-embolization would be better to avoid complications such as liver necrosis and liver failure.
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