Hypothesis: Radiofrequency thermal ablation (RFA) can be performed safely and effectively to control local disease in patients with advanced, unresectable liver tumors. Design, Setting, and Patients: Prospective study of 76 patients with unresectable liver tumors who underwent RFA at a private tertiary referral hospital. Interventions: Ninety-nine RFA operations were performed to ablate 328 tumors. Main Outcome Measures: Complications and local recurrence.Results: There was 1 death (1%), major complications occurred in 7 operations (7%), and minor complications occurred in 10 operations (10%). Local recurrence was identified in 30 tumors (9%) at a mean follow-up of 15 months. Size (PϽ.001), vascular invasion (PϽ.001), and total volume ablated (PϽ.001) were associated with recurrence but the number of tumors was not (P=.39). Conclusion:Radiofrequency thermal ablation provides local control of advanced liver tumors with low recurrence and acceptable morbidity.

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Two commercially available kits have been used to create 25 percutaneous tracheostomies, 20 using the Cook system and five using the Rapitrac system. The operation time and complication rates of these tracheostomies have been compared with those for 16 conventional tracheostomies performed for similar indications. Median operating times were 60 (range 30-105) min for conventional tracheostomy, 15 (range 8-70) min for Cook and 5 (range 3-15) min for Rapitrac systems (P less than 0.001). A significantly higher proportion of patients in the Rapitrac group had complications compared with the other two groups (P less than 0.05). The complication rate for the Cook group compared favourably with that for the conventional tracheostomy group. The Cook system of percutaneous tracheostomy is a simple, rapid and safe alternative to conventional tracheostomy.