Percutaneous ultrasound-guided thermal ablation for liver tumor with artificial pleural effusion or ascites.
Percutaneous ultrasound-guided thermal ablation for liver tumor with artificial pleural effusion or ascites.
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DOI：
10.5732/cjc.010.10095
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发表时间：
2010-09
影响因子：
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通讯作者：
Lin-Na Liu;Hui-Xiong Xu;Ming-de Lu;Xiao-yan Xie
中科院分区：
文献类型：
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作者：
Lin-Na Liu;Hui-Xiong Xu;Ming-de Lu;Xiao-yan Xie
背景与目的经皮超声引导热消融术是肝癌的主要治疗方法之一。肿瘤位置靠近横膈膜或胃肠道，由于肿瘤的可见性差或增加邻近器官热损伤的风险，之前被视为治疗禁忌症。本研究利用人工胸水或腹水扩大肝癌热消融治疗的适应证。方法对56例经皮肝肿瘤热消融治疗中的疑难病例进行人工胸水（20例）或腹水（36例）引流。评估了技术成功率、接近手术目标率、并发症和局部治疗反应。结果人工胸腔积液和人工腹水的技术成功率分别为95%（19/20）和100%（36/36），达到目的率分别为100%（19/19）和91.7%（33/36），完全消融率分别为84.2%（16/19）和93.9%（31/33）。3例患者在人工胸腔积液过程中出现咳嗽、一过性血尿和皮下积液，1例患者在人工腹水过程中出现右胸积液。结论人工胸腹水热消融治疗肝肿瘤安全有效，可拓宽肝肿瘤热消融治疗的适应证。
BACKGROUND AND OBJECTIVE Percutaneous ultrasound-guided thermal ablation is one of the major treatment methods for liver cancer. Tumor location close to the diaphragm or gastrointestinal tract was regarded as the treatment contraindication before due to poor visibility of the tumor or increased risk of thermal injury to the adjacent organs. This study used artificial pleural effusion or ascites to extend the indications of thermal ablation for liver cancer. METHODS Artificial pleural effusion (20 cases) or ascites (36 cases) was performed in 56 difficult cases of percutaneous thermal ablation for liver tumors. The technical success rates, the rate of approaching the procedure goal, complications, and local treatment response were assessed. RESULTS The technical success rates were 95% (19/20) for artificial pleural effusion and 100% (36/36) for artificial ascites, the achieve purpose rates were 100% (19/19) and 91.7% (33/36), the complete ablation rates were 84.2% (16/19) and 93.9% (31/33), respectively. Coughing, transient hematuria, and subcutaneous effusion were observed in 3 patients after the procedure of artificial pleural effusion, and hydrothorax in the right chest occurred in 1 patient during the artificial ascites process. CONCLUSIONS Thermal ablation with the use of artificial pleural effusion or ascites is a safe and effective treatment for liver tumors, and the technique can widen the indications of thermal ablation for liver tumors.