The safety of radiofrequency thermal ablation in the treatment of liver malignancies
The safety of radiofrequency thermal ablation in the treatment of liver malignancies
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DOI：
10.1016/j.ejso.2007.05.003
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发表时间：
2008-06-01
期刊：
影响因子：
3.8
通讯作者：
Nicoli, N.
中科院分区：
文献类型：
--
作者：
Casaril, A.;Abu Hilal, M.;Nicoli, N.
简介：射频消融（RFA）已被广泛接受为肝脏手术的重要辅助手段，有时甚至是可行的替代方案。本研究的目的是评估与经皮射频消融相关的风险，并讨论其use.Patients和方法的适应症和禁忌症：这是一个审查的130例连续患者谁被治疗原发性（n = 92）和转移性（n = 38）肝肿瘤。仅评价了经皮射频消融术（83例患者）后的并发症。有趣的案例研究包括突出潜在的并发症RFA及其management.Results：一名患者死于结肠穿孔和其他五个有重大并发症。有15例轻微并发症。局部复发率总体达到30%，另外25例患者出现了新的肝脏病变，与RFA治疗的病变不同。中位无病生存期为13个月。总生存率在1，2和5年分别为85.3%，71.3%和57.6%，respectively。结论：经皮射频消融是一种安全，有效的技术，但并非没有并发症和潜在的致命后果。它也与显著的局部复发率相关。该手术应仅在经过充分培训后进行，并且应始终在多学科会议上讨论适应症。必须考虑患者的肝功能和一般健康状况以及肿瘤的大小和位置。术中或视频腹腔镜RFA可用于浅表肿瘤，以避免损伤肝脏表面周围的内脏。(c)2007爱思唯尔有限公司保留所有权利。
Introduction: Radiofrequency ablation (RFA) has become widely accepted as an important adjunct, and sometimes a viable alternative, to liver surgery. The aims of this study are to assess the risks associated with percutaneous RFA and to discuss the indications and contraindications to its use.Patients and methods: This is a review of 130 consecutive patients who were treated for primary (n = 92) and metastatic (n = 38) liver tumours. Only complications after percutancous RFA (83 patients) were evaluated. Interesting case studies are included to highlight potential complications following RFA and their management.Results: One patient died of perforation of the colon and five others had major complications. There were 15 minor complications. Local recurrence rates reached 30% overall, and a further 25 patients developed a new hepatic lesion, different from the one treated by RFA. Median disease-free survival was 13 months. Overall survival rates at 1, 2 and 5 years were 85.3%, 71.3% and 57.6%, respectively.Conclusion: Percutaneous RFA is a safe and efficient technique but not free of complications and with potential fatal outcome. It is also associated with significant local recurrence rates. The procedure should only be performed following adequate training and the indication should always be discussed in multidisciplinary meetings. Patient's liver function and general health as well as tumour size and position must be considered. Intraoperative or video laparoscopic RFA is useful for superficial tumours in order to avoid damage to viscera surrounding the liver surface. (c) 2007 Elsevier Ltd. All rights reserved.