A case of open microwave coagulo-necrotic therapy (MCT) via the middle hepatic vein for metastatic liver tumor neighboring the paracaval portion

We experienced a patient who underwent open MCT with the needle advanced via the middle hepatic vein for a metastatic liver tumor neighboring the paracaval portion. Open MCT was performed under hepatic inflow and outflow block to reduce the cooling effect by the blood flow. The operation was uneventfully performed, and no complications such as massive hemorrhage from middle hepatic vein, pulmonary infarction nor congestion in the drainage area of middle hepatic vein occurred. There was no evidence of local recurrence and other intrahepatic or extrahepatic metastases within 11 months after the operation. In conclusion, open MCT under hepatic inflow and outflow block is effective for tumors adjacent to a major hepatic vein. There was no complication when open MCT was performed by penetrating a major hepatic vein.