Percutaneous Radiofrequency Ablation for Hepatic Tumors Abutting the Diaphragm: Clinical Assessment of the Heat-Sink Effect of Artificial Ascites

Abstract

Artificial ascites did not show a heat-sink effect on the volume of the ablation zone after percutaneous RFA for the treatment of a hepatic tumor abutting the diaphragm.

Percutaneous Radiofrequency Ablation of Hepatocellular Carcinoma against the Diaphragm: Is Artificial Ascites Necessary?

“…The mean volume of 47.8 cm 3 and 38.1 cm 3 in the perdiaphragmatic versus non-peridiaphragmatic groups, respectively, is comparable to previous literature [38]. The lack of significant difference in minor complications agrees with Nam et al [38].…”

“…Our recurrence rates are similar to Head, et al [7], but increased compared to Nam, et al [38]. But similar to our study, they demonstrated no statistical difference in recurrence rates between the two groups.…”

“…The mean volume of 47.8 cm 3 and 38.1 cm 3 in the perdiaphragmatic versus non-peridiaphragmatic groups, respectively, is comparable to previous literature [38]. The lack of significant difference in minor complications agrees with Nam et al [38]. However, they differ from findings of Kang et al [26] that demonstrated increased minor complications/side effects in RFA of lesions adjacent to the diaphragm, but only statistically significant in the subgroups of right shoulder pain symptoms and transient nonclinical lung injury.…”

“…However, the induction of artificial ascites prior to ablation can have possible potential drawbacks such as increased procedure time, incomplete success rate in patients with postoperative adhesions, and risk for bleeding, peritonitis, seeding, and increased rates of local tumor progression [31]- [38]. Given these potential drawbacks, we raise the question of its true utility.…”

Creación de ascitis artificial para el tratamiento mediante radiofrecuencia percutánea del hepatocarcinoma cercano al diafragma

“…Demostraron que no existían diferencias estadísticamente significativas en los tres grupos en cuanto al tamaño del área de la ablación (210,4774,3, 158,3778,8, 133749,7 mm 2 respectivamente; p¼ 0,188) 28 . En otro reciente estudio realizado en 28 pacientes donde se compara el volumen de ablación y la progresión local del tumor en pacientes tratados mediante RFp con ascitis y RFp convencional, se concluye que no existen diferencias estadísticamente significativas ni en cuanto al volumen del tumor tratado (p ¼0,871) ni en la progresión local del mismo (p ¼ 0,83) 29 .…”