Treatment of focal liver tumors with percutaneous radio-frequency ablation: Complications encountered in a multicenter study
Treatment of focal liver tumors with percutaneous radio-frequency ablation: Complications encountered in a multicenter study
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DOI：
10.1148/radiol.2262012198
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发表时间：
2003-02-01
期刊：
影响因子：
19.7
通讯作者：
Goldberg, SN
中科院分区：
文献类型：
--
作者：
Livraghi, T;Solbiati, L;Goldberg, SN
目得：报告并发症所遇到的一个协作组的成员进行射频（RF）消融术的患者与局灶性liver cancer.MATERIALS和METHODS：成员的41个意大利中心，是一个协作组的一部分，使用了经皮内部冷却射频消融技术和标准化的后续协议。他们完成了一份关于死亡人数、推定死亡原因及其与RF手术关系的可能性、重大并发症的数量和类型以及轻微并发症和副作用的类型的问卷。入组了2，320例3个SS 4病变（直径3.1 cm +/- 1.1 [SD]）的患者：1，610例肝细胞癌伴慢性肝病; 693例转移，主要来自结直肠癌（n = 501）; 17例胆管细胞癌。报告了归因于手术的并发症（即，死亡以及重大和轻微并发症）的数量和特征。数据随后进行方差分析，以确定主要并发症发生率是否与肿瘤大小，消融次数或电极类型（单个或簇）有关。观察到6例死亡（0.3%），包括2例由肠穿孔后多器官衰竭引起的死亡; 1例由金黄色葡萄球菌引起的腹膜炎后感染性休克、1例肿瘤破裂后大出血、1例右胆管狭窄后肝功能衰竭引起的死亡; 1例术后3天不明原因猝死。50例（2.2%）患者发生其他严重并发症。其中最常见的是腹膜出血、肿瘤种植、肝内脓肿和肠穿孔。射频治疗次数的增加与严重并发症的发生率较高相关（P <0.01），而当比较肿瘤大小或电极类型时，并发症的数量没有显著差异。轻微的并发症，观察不到5%的patients.CONCLUSION：本研究的结果证实，射频消融治疗局灶性肝肿瘤是一个相对低风险的程序。
PURPOSE: To report complications encountered by members of a collaborative group who performed radio-frequency (RF) ablation in patients with focal liver cancer.MATERIALS AND METHODS: Members of 41 Italian centers that were part of a collaborative group used a percutaneous internally cooled RF ablation technique and a standardized protocol for follow-up. They completed a questionnaire regarding number of deaths, presumed cause of death, and likelihood of its relationship to the RF procedure; number and types of major complications; and types of minor complications and side effects. Enrollment included 2,320 patients with 3,SS4 lesions (size, 3.1 cm +/- 1.1 [SD] in diameter): 1,610 had hepatocellular carcinoma with chronic liver disease; 693 had metastases, predominantly from colorectal cancer (n = 501); and 17 had cholangiocellular carcinoma. Number and characteristics of complications (ie, deaths and major and minor complications) attributed to the procedure were reported. Data were subsequently analyzed with analysis of variance to determine whether the major complication rate was related to tumor size, number of ablation sessions, or electrode type (single or cluster).RESULTS: In total, 3,554 lesions were treated. Six deaths (0.3%) were noted, including two caused by multiorgan failure following intestinal perforation; one case each of septic shock following Staphylococcus aureus-caused peritonitis, massive hemorrhage following tumor rupture, liver failure following stenosis of right bile duct; and one case of sudden death of unknown cause 3 days after the procedure. Fifty (2.2%) patients had additional major complications. The most frequent of these were peritoneal hemorrhage, neoplastic seeding, intrahepatic abscesses, and intestinal perforation. An increased number of RF sessions were related to a higher rate of major complications (P < .01), whereas the number of complications was not significantly different when tumor size or electrode type were compared. Minor complications were observed in less than 5% of patients.CONCLUSION: Results of this study confirm that RF ablation is a relatively low-risk procedure for the treatment of focal liver tumors.