Percutaneous Microwave Ablation in the Spleen for Treatment of Hypersplenism in Cirrhosis Patients

Jiang, Xiangwu; Gao, Fei; Ma, Yan; Feng, Shufen; Zhou, Hong-ke

doi:10.1007/s10620-015-3732-7

Cited by 13 publications

(13 citation statements)

References 6 publications

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“…In our study, complications like pleural effusion, severe pain occurred more in PSE and the two sessions of microwave than one session. This is in agreement with Jiang et al [18], who found less complication in microwave groups than PSE group and increased complications with the increased ablated areas with microwave ablation. Also, this was in agreement to other studies done by Cai et al [19] and Gonsalves et al [20], who found that tense ascites, bacterial peritonitis, and post-embolization syndrome (fever, pain, vomiting) were the complications after PSE.…”

Section: Discussionsupporting

confidence: 93%

Percutaneous Microwave Ablation versus Partial Splenic Embolization for Treatment of Hypersplenism in Patients with Liver Cirrhosis

Asar

Kady

Alegaily

et al. 2019

Afro-Egyptian Journal of Infectious and Endemic Diseases

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Background and study aim: In patients suffering from portal hypertension as result of liver cirrhosis, hypersplenism was ranged from 11 to 55%. The aim of our work was to compare between percutaneous microwave ablation (MWA) and partial splenic artery embolization (PSE) in the management of hypersplenism in patients with liver cirrhosis as regard efficacy and safety. Patients and Methods: Sixty patients with liver cirrhosis complicated with splenomegaly and hypersplenism were divided randomly into three groups; Group (1): Twenty patients were underwent one session of MW ablation of splenic parenchyma with target ablation volume about 20%, Group (2): Twenty patients were underwent two sessions of MW ablation of splenic parenchyma with 1 week interval with target ablation up to 40%, Group (3): Twenty patients were underwent PSE. Results: There was an improvement in the hemoglobin, platelet and leucocyte levels in three groups, which was 9.47± 2.14 gm/dl, 42.75 ± 15.4 x10 3 / mm 3 and 2.6±0.5 x10 3 /mm 3 before the procedure respectively and become 9.95 ± 2.29 gm/dl, 313.5±99.6 x10 3 /mm 3 and 6.88± 1.89 x10 3 /mm 3 after one month as regard PSE group. As regard one session of MWA was 9.73±2.02 gm/dl, 45.57±11.2 x10 3 /mm 3 and 2.8±0.85 x10 3 /mm 3 and become 11.83±0.74 gm/dl, 152±26.43 x10 3 /mm 3 and 5.85±1.01 x10 3 /mm 3 after one month. As regard two sessions of MWA group; was 9.2±2.15 gm/dl, 40.6± 11.5 x10 3 /mm 3 and 2.4±0.55 x10 3 /mm 3 and become 12.74±1.2 gm/dl, 183.4± 26.43 x10 3 /mm 3 and 6.29±1.17 x10 3 /mm 3 after one month. PSE was significantly more effective in the elevation of platelets and leucocytes than other two groups (p=0.00), and two sessions of MWA more than one session of MWA. The two sessions MWA group was significantly higher than other two groups while one session of MWA group was more than PSE group in the elevation of hemoglobin (p=0.00). No mortality occurred in the three groups, but PSE was associated with more serious complications than the other two groups. Conclusion: MWA and PSE were effective in treatment of hypersplenism in patients with liver cirrhosis, while percutaneous MWA has less serious complications than PSE.

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Section: Discussionsupporting

confidence: 93%

Percutaneous Microwave Ablation versus Partial Splenic Embolization for Treatment of Hypersplenism in Patients with Liver Cirrhosis

Asar

Kady

Alegaily

et al. 2019

Afro-Egyptian Journal of Infectious and Endemic Diseases

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“…The retention theory argues that the portal vein pressure will affect the retention time of blood cells in the spleen. The higher the velocity of splenic artery is, the wider the diameter of splenic vein is and the larger the blood flow of splenic vein is, the lower the platelet count will be ( 16 ). The research results showed that the peak velocity of splenic artery in observation group was significantly lower than that in control group after 1 week of treatment, and the diameter, velocity and flow of splenic vein were significantly lower than those in control group (P<0.05).…”

Section: Discussionmentioning

confidence: 99%

Analysis of feasibility, safety and effectiveness of ultrasound-guided percutaneous microwave ablation of splenic neoplasm

et al. 2018

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The present study aimed to analyze the feasibility, safety and effectiveness of ultrasound-guided percutaneous microwave ablation of splenic neoplasm. A total of 62 patients with splenic neoplasm admitted to Second People's Hospital of Liaocheng between January 2009 and December 2012 were selected, and randomly divided into the observation group (n=31) and control group (n=31). The control group was treated with open ablation, while the observation group was treated with ultrasound-guided percutaneous microwave ablation. The splenic hemodynamics and ablation effects of patients after treatment were detected via color Doppler ultrasound. The changes in peripheral blood cell count before treatment, and at 3, 7 and 14 days after treatment were monitored. The side effects and complications were compared between the two groups. Patients were followed up for 5 years to observe the survival rates of the two groups. At 1 week after treatment, the peak velocity of splenic artery in observation group was significantly lower than that in control group, and the diameter, velocity and flow of splenic vein were significantly lower than those in control group (P<0.05). After treatment, the white blood cell and platelet counts in both groups were significantly increased compared with those before treatment, and the counts in observation group were obviously higher than those in control group (P<0.05). There were no significant changes in the red blood cell counts in both groups before and after treatment (P>0.05). The ablation volume, ablation ratio and 1-week shrink ratio in both groups had no significant differences (P>0.05). The incidence rates of side effects and complications in observation group were significantly lower than those in control group (P<0.05). The 5-year survival rates of both groups were >50%, and the survival time and survival rate were not significantly different (P<0.05). The curative effects of open ablation and ultrasound-guided percutaneous microwave ablation in the treatment of splenic neoplasm were significant, and the 5-year survival rate of patients was higher; compared with open ablation. The ultrasound-guided percutaneous microwave ablation is characterized by the small trauma, lower incidence rates of adverse reactions and complications and better safety, which can increase the peripheral blood cell count, and improve the splenic blood flow and coagulation function, playing a role in the regulation of the patient's body status.

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“…Chinese researchers have evaluated MWA as a technique to preserve part of the spleen in the treatment of hypersplenism and splenic tumours. For hypersplenism, the higher the splenic volumes that were ablated (over 40-50%), the more the levels of leukocytes, platelets and peripheral lymphocyte subsets improved [77][78][79]. Jiang et al [79] completed the latest study with the largest patient sample and evaluated the effects of MWA in 38 patients with secondary hypersplenism caused by hepatic cirrhosis.…”

Section: Mwa In the Spleenmentioning

confidence: 99%

Status and advancement of microwave ablation in China

Liang

2016

International Journal of Hyperthermia

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Tumour ablation is defined as the direct application of chemical or thermal therapy to eradicate or substantially destroy a tumour. Currently, minimally invasive ablation techniques are available for the local destruction of focal tumours in multiple organ sites. Microwave ablation (MWA) is premised on the biological response of solid tumours to tissue hyperthermia, and it is a relatively low-risk procedure. Due to several advantages of MWA, including higher thermal efficiency, higher capability for coagulating blood vessels, faster ablation time and the simultaneous application of multiple antennae, MWA could be a promising minimally invasive ablation technique for the treatment of solid tumours. Therefore, the use of MWA has developed rapidly in China during the last decade. Many successful studies have been performed, and widespread use has been achieved for multiple types of tumours in China, especially for liver cancer. This review will describe the state-of-the-art of MWA in China, including the development of MWA equipment and its application in the treatment of multiple types of tumours.

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Percutaneous Microwave Ablation in the Spleen for Treatment of Hypersplenism in Cirrhosis Patients

Cited by 13 publications

References 6 publications

Percutaneous Microwave Ablation versus Partial Splenic Embolization for Treatment of Hypersplenism in Patients with Liver Cirrhosis

Percutaneous Microwave Ablation versus Partial Splenic Embolization for Treatment of Hypersplenism in Patients with Liver Cirrhosis

Analysis of feasibility, safety and effectiveness of ultrasound-guided percutaneous microwave ablation of splenic neoplasm

Status and advancement of microwave ablation in China

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