Transpulmonary radiofrequency ablation for hepatocellular carcinoma under real-time computed tomography-fluoroscopic guidance.
Transpulmonary radiofrequency ablation for hepatocellular carcinoma under real-time computed tomography-fluoroscopic guidance.
复制标题
DOI：
--
复制
发表时间：
2008-07
影响因子：
--
通讯作者：
Takeharu Kato;T. Yamagami;T. Hirota;Tomohiro Matsumoto;R. Yoshimatsu;T. Nishimura
中科院分区：
文献类型：
--
作者：
Takeharu Kato;T. Yamagami;T. Hirota;Tomohiro Matsumoto;R. Yoshimatsu;T. Nishimura
背景/目的射频消融术已被公认为是不可切除的恶性肝肿瘤的安全治疗方法。肿瘤下方的圆顶可能很难可视化超声。本研究的目的是评估在实时计算机断层X线透视引导下经肝穿刺射频消融治疗肝细胞癌的应用。方法：2002年12月至2006年4月，在计算机断层X线透视引导下，对22例患者进行了24次经皮穿刺射频消融治疗。所有患者的肝细胞癌均在肿瘤顶下方小于3cm。结果在实时CT-透视引导下经肺射频消融术均成功完成。22例（92%）在射频消融后平均8个月进行的随访动态计算机断层扫描中无局部肿瘤复发。主要并发症为9例手术后的气胸（38%）：6例患者的气胸在随访胸片上完全消退，3例患者在射频消融后立即进行手动抽吸治疗，无患者需要放置胸管。结论计算机断层扫描-荧光镜引导下经肺射频消融是一种准确、安全地消融超声检查无法检测到的肝细胞癌的有效方法。
BACKGROUND/AIMS Radiofrequency ablation has been accepted as a safe treatment for unresectable malignant hepatic tumors. Tumors beneath the diaphragmatic dome may be difficult to visualize with ultrasonography. The aim of this study was to assess the use of transpulmonary radiofrequency ablation under real-time computed tomography-fluoroscopic guidance for hepatocellular carcinoma. METHODOLOGY Twenty-four radiofrequency ablation treatments by means of a transpulmonary approach were performed in 22 patients under computed tomography-fluoroscopic guidance between December 2002 and April 2006. Every patient had a hepatocellular carcinoma less than 3cm in size beneath the diaphragmatic dome. RESULTS Transpulmonary radiofrequency ablation under real-time computed tomography-fluoroscopic guidance was successfully performed in every procedure. There was no local tumor recurrence in 22 cases (92%) on follow-up dynamic computed tomography performed an average of 8 months after radiofrequency ablation. The major complication was pneumothorax after 9 procedures (38%): pneumothorax in 6 patients had completely resolved on follow-up chest radiographs, and was treated with manual aspiration immediately after radiofrequency ablation in 3 patients, and no patients required chest-tube placement. CONCLUSION Transpulmonary radiofrequency ablation under computed tomography-fluoroscopic guidance is a useful method for the accurate and safe ablation of hepatocellular carcinoma that is not detectable with ultrasonography.