Adverse Events During Radiofrequency Treatment of 582 Hepatic Tumors

Baère, Thierry De; Risse, Olivier; Kuoch, Viseth; Dromain, Clarisse; Sengel, C; Smayra, Tarek; Din, Mostafa Gamal El; Létoublon, Christian; Élias, Dominique

doi:10.2214/ajr.181.3.1810695

Cited by 438 publications

(321 citation statements)

References 35 publications

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“…All of the rest are considered minor [3] . Authors have reported rates as low as 2% to 5.7% for major complications [4][5][6] . Mortality related to the procedure is low, reported in the literature to be less than 1% [7][8][9] .…”

Section: Topic Highlightmentioning

confidence: 99%

“…Intra-abdominal bleeding is the most common complication encountered in many studies [5,6,12,13] . In Mulier's review, it occurred in 0.7% of the procedures in 3670 patients [12] .…”

Section: Hemorrhagic Complicationsmentioning

confidence: 99%

“…Despite the low number of patients and the lack of a control group, the authors suggest that this regimen may decrease the incidence of hepatic abscess. Elias et al [23] and de Baère et al [5] also debated this matter. Both groups administered prolonged antibiotics prophylaxis for 5 d (longer than usual) on these high-risk patients and a high incidence of hepatic abscess was encountered.…”

Section: Infectionmentioning

confidence: 99%

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Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

Fonseca

Santin

Gomes

et al. 2014

WJH

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Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe. Thus, complications occur and vary widely in the literature. Complications are caused by thermal damage, direct needle injury, infection and the patient's co-morbidities. Tumor type, type of approach, number of lesions, tumor localization, underlying hepatic disease, the physician's experience, associated hepatic resection and lesion size have been described as factors significantly associated with complications. The physician in charge should promptly recognize high-risk patients more susceptible to complications, perform a close post procedure follow-up and manage them early and adequately if they occur. We aim to describe complications from RFA of hepatic tumors and their risk factors, as well as a few techniques to avoid them. This way, others can decrease their morbidity rates with better outcomes.

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Section: Topic Highlightmentioning

confidence: 99%

“…Intra-abdominal bleeding is the most common complication encountered in many studies [5,6,12,13] . In Mulier's review, it occurred in 0.7% of the procedures in 3670 patients [12] .…”

Section: Hemorrhagic Complicationsmentioning

confidence: 99%

Section: Infectionmentioning

confidence: 99%

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Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

Fonseca

Santin

Gomes

et al. 2014

WJH

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“…Among the cutting-edge technologies, is highlighting the use of RF as well known in the therapeutic armamentarium ablation of liver lesions 3,4,11,12,21 . Recent studies have shown 3,13,14,22,25 hepatectomies performed using the monopolar RF, where the blood loss and the occurrence of fistula bile was almost nil.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, the RF ablation of tumors has allowed patients with low functional reserve had controlled their lesions, leading to waiting for transplantation in patients with primary tumors 4,11,12 , or allowing an increase in its survival in cases of metastatic lesions 21 . However, despite the appropriate use of RF ablation, local recurrence at the site of ablation varies around 40% 3 .…”

Section: Discussionmentioning

confidence: 99%

É possível diminuir o sangramento em hepatectomias sem a realização de exclusão vascular total ou parcial?: Resultados do uso de radiofrequência bipolar com agulhas resfriadas

Sampaio¹,

Waechter²,

Passarin³

et al. 2011

ABCD, arq. bras. cir. dig.

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RACIONAL: Embora a ressecção seja ainda o procedimento de escolha no tratamento curativo das lesões malignas do fígado, o sangramento permanece como fator de morbidade com grande impacto na cirurgia hepática. Com o intuito de minimizar esta complicação, diversas opções tecnológicas têm sido utilizadas, entre elas mais recentemente a radiofrequência, permitindo que o procedimento seja realizado com incisões menores, sem necessidade de clampeamento vascular, com mínima dissecção hepática, ou sangramento. OBJETIVO: Apresentar os resultados em uma série de pacientes utilizando nova técnica de ressecção do parênquima hepático através de agulhas paralelas de radiofrequência bipolar desenvolvidas pelos próprios autores, verificando o impacto no sangramento trans-operatório dos pacientes submetidos à hepatectomias. MÉTODOS: Sessenta pacientes foram submetidos à ressecção hepática através do uso da radiofrequência bipolar. O sangramento per-operatório foi avaliado através da medição do volume coletado em aspirador e pela diferença de peso nas compressas utilizadas durante o procedimento. Todos os casos foram acompanhados em sua função hepatocitária através de exames laboratoriais durante a primeira semana de pós-operatório. RESULTADOS: As ressecções hepáticas foram realizadas com média de 87 minutos, tamanho médio da incisão abdominal de 14 cm e sangramento médio de 58 mililitros. Nenhum paciente recebeu transfusão de sangue ou derivados. Não foram utilizados cateteres venosos centrais. Todos pacientes obtiveram rápida recuperação anestésica, obtendo alta da sala de recuperação para a enfermaria em menos de 12 horas. A drenagem pós-operatória foi anotada até a retirada do dreno abdominal em todos os pacientes. O tempo de internação hospitalar médio foi de 3,2 dias. Após um pico de elevação das provas de função hepática nos primeiros três dias, todos apresentaram retorno destes exames aos parâmetros pré-operatórios ao final do 1o mês. CONCLUSÃO: É possível, factível e válida a utilização de agulhas de radiofrequência para a realização de hepatectomias, mesmo maiores, reduzindo o sangramento.

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Safety Limit of Large-Volume Hepatic Radiofrequency Ablation in a Rat Model

Ng¹

2006

Arch Surg

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Adverse Events During Radiofrequency Treatment of 582 Hepatic Tumors

Abstract: Radiofrequency ablation of liver tumors is a well-tolerated technique, but caution should be exercised when treating patients with a bilioenteric anastomosis, and radiofrequency ablation during vascular occlusion in cirrhotic livers should be avoided.

Cited by 438 publications

References 35 publications

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

É possível diminuir o sangramento em hepatectomias sem a realização de exclusão vascular total ou parcial?: Resultados do uso de radiofrequência bipolar com agulhas resfriadas

Safety Limit of Large-Volume Hepatic Radiofrequency Ablation in a Rat Model

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