Complications of radiofrequency coagulation of liver tumours

Abstract

Background: Radiofrequency coagulation (RFC) is being promoted as a novel technique with a low morbidity rate in the treatment of liver tumours. The purpose of this study was to assess critically the complication rates of RFC in centres with both large and limited initial experience, and to establish causes and possible means of prevention and treatment. The morbidity and mortality of RFC, while low, is higher than previously assumed. With adequate knowledge, many complications are preventable.

Microwave ablation for unresectable hepatic tumours: Clinical results using a novel microwave probe and generator

“…No other early post operative deaths were encountered during the study or until the time of writing. The 30-day mortality rate observed in this study is again at least comparable to other similar studies using RF and Cryotherapy (3,5).…”

“…None of the patients in this series showed evidence of sepsis, bile duct damage, thrombocytopaenia, or significant systemic upset. This compares very favourably with studies of alternative ablative modalities which have reported complications in up to 33% of the patients treated (3,4). In spite of the fact that some individuals underwent large volume microwave ablations, none of the patients in this study exhibited symptoms similar to that which M A N U S C R I P T…”

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

“…Mortality related to the procedure is low, reported in the literature to be less than 1% [7][8][9] . 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 [9][10][11][12] . In one of their papers, Poon et al [10] concluded that after the physician's first 50 procedures, the incidence of complications is lower, as well as a shorter hospital stay and higher complete ablation rate.…”

“…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] .…”

Distant Infusion of Saline May Enlarge Coagulation Volume During Radiofrequency Ablation of Liver Tissue Using Cool-tip Electrodes Without Impairing Predictability

“…Inside the electrode, a closed water circulation system cools the tis- the "low" predictability and the variability of coagulation shape. Accurate prediction of ablation data and geometry are important to prevent local tumor recurrence [15] or collateral damage [16][17][18].…”