ABSTRACT
Objective To evaluate the clinical value of artificial pleural effusion for percutaneous microwave ablation of liver cancer in the hepatic dome. Methods 28 difficult cases (total 34 lesions), all lesions were located in the hepatic dome and covered by lung. Infused with artificial pleural effusion by ultrasound real-time monitoring before percutaneous ultrasound-guided microwave ablation. The amount of artificial pleural effusion, the technique successful rate,the rate of lesions revealed, local treatment response and complications had been observed. Results The amount of artificial pleural effusionwas 200-1 000 mL [(388 ± 107)mL]. The technique successul rate of artificial pleural effusion was 100% (28 / 28), the rate of lesions revealed was 85.3%(29 / 34), the other 5 isoechoic lesions were revealed by contrast-enhanced ultrasound. All the 34 lesions was ablated completely, the complete ablation rate was 100%(34 / 34). the rate of complications was 2.9%(1 / 34), 1 patient was found a small amount of intraperitoneal hemorrhage after ablation. Conclusions Artificial pleural effusion assisted percutaneous microwave ablation of liver cancer in the hepatic dome is a safe , effective treatment, it broadened the percutaneous microwave ablation therapeutic range, and should be more widely used in clinically.
ABSTRACT
Objective: To investigate the technical procedure, clinical efficacy and safety of extrathoracic and transhepatic CT-guided radiofrequency ablation (CT-RFA) for liver cancer in hepatic dome area. Methods: A retrospective analysis was conducted in 50 patients who were diagnosed of primary liver cancer or metastatic liver cancer and received CT-RFA between September 2003 and October 2012. The total number of the malignant lesions in the hepatic dome area were 59. The detailed technical procedure, clinical efficacy and the safety as well as the factors related to local recurrence-free survival were anaylized and summarized. Results: The pathway for needle puncture of RT-RFA in treatment of the malignant lesions in the hepatic dome area was established by using a new "cube" model. The rates of technical success in RFA and complete necrosis were 94.92% (56/59) and 84.75% (50/59), respectively. The median local recurrence-free survival time of patients with completely necrotic lesions was 1 2.05 months, which for primary liver cancer and metastatic liver cancer were 14.23 and 8.07 months, respectively (P = 0.037). Three patients developed severe complications after RFA, and recovered after supportive treatment. The multivariable analysis revealed that the tumor size was an independent factor related to the local recurrence-free survival (P = 0.028). Conclusion: CT-RFA for the treatment of malignant lesions in the hepatic dome area is safe and effective. The tumor size is an independent risk factor related to the local recurrence-free survival. Copyright© 2014 by TUMOR.