Percutaneous Radiofrequency Ablation with Artificial Ascites for Hepatocellular Carcinoma in the Hepatic Dome: Initial Experience

Rhim, Hyunchul; Lim, Hyo Keun; Kim, Youngsun; Choi, Dongil

doi:10.2214/ajr.07.2384

Cited by 135 publications

(101 citation statements)

References 35 publications

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“…As a result, a relatively large amount of liquid (1-3 L) or continuous infusion is often necessary to ensure adequate protection which can result in patient discomfort following the procedure. 6,[17][18][19][20][21][22][23] We evaluated the feasibility of an alternative to conventional liquids: an aqueous poloxamer 407 (P407) hydrodissection material. Poloxamers are polyethylene oxidepolypropylene oxide-polyethylene oxide (PEO-PPO-PEO) triblock copolymers that traditionally serve as nonionic surfactants.…”

Section: Introductionmentioning

confidence: 99%

Design and validation of a thermoreversible material for percutaneous tissue hydrodissection

Johnson¹,

Sprangers

Cassidy

et al. 2013

J. Biomed. Mater. Res.

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Interventional oncology procedures such as thermal ablation are becoming routine for many cancers. Hydrodissection-separating tissues with fluids-protects tissues near the treatment zone to improve ablation's safety and facilitate more aggressive treatments. However, currently used fluids such as normal saline and 5% dextrose in water (D5W) migrate in the peritoneum, reducing their protective efficacy. As a hydrodissection alternative, we investigated a thermoreversible poloxamer 407 (P407) solution. Such a material can be injected as a liquid which then forms a semi-solid gel at body temperature without syneresis. The desired gelation temperature of 32°C was achieved with 15.4 wt/wt % P407. Viscosity analysis revealed the lowest viscosity and ideal injection point was at 14°C. Solution viscosity increased during gelation, to a peak of 65 kPa*s at 40°C. The electrical impedance of P407 was significantly greater than isotonic saline, but lower than D5W, indicating its potential for electrical protection. The P407 gel was similar to other hydrodissection fluids at ultrasound and CT imaging. Ex vivo liver ablations showed that P407 protects neighboring tissues, but may require a thicker barrier for comparable protection to D5W. Overall, we found that the P407 solution is a feasible alternative to traditional hydrodissection fluids and warrants additional study.

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Section: Introductionmentioning

confidence: 99%

Design and validation of a thermoreversible material for percutaneous tissue hydrodissection

Johnson¹,

Sprangers

Cassidy

et al. 2013

J. Biomed. Mater. Res.

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show abstract

“…Adjacent visceral organs, such as small bowel or colon, can be displaced away from the tumor through patient positioning or hydrodissection (16). Hydrodissection can also be used to displace the diaphragm to prevent diaphragmatic injury during the ablation of tumors in the liver dome (17). Hydrodissection should be performed with sterile water or 5% dextrose rather than saline because the latter conducts electricity.…”

Section: Rf Ablation In Liver Tumorsmentioning

confidence: 99%

Radiofrequency ablation: technique and clinical applications

Tatlı

Tapan²,

Morrison³

et al. 2011

Diagn Interv Radiol

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Radiofrequency ablation is the most commonly used percutaneous ablation technique and well-documented in the literature on focal therapies. It has become the image-guided ablation method of choice because of its efficacy, safety, and ease of use. Radiofrequency ablation has shown promise in treating selected solid tumors, particularly those involving the liver, kidneys, lungs, and the musculoskeletal system. It is a minimally invasive technique often used in inoperable patients with other comorbidities. Radiofrequency ablation requires a minimal hospital stay or can be performed on an outpatient basis. The aim of this article is to review radiofrequency ablation techniques and their clinical applications.

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“…Local ablation therapy under laparoscopy or thoracoscopy could be a possible treatment in such case, but it is more invasive than percutaneous procedure and other special equipment would be needed. The artificial pleural or peritoneal effusion has been explored as a beneficial treatment option that offers excellent local control through visualization of hepatocellular carcinoma under the diaphragm (Katayama et al, 2002;Uehara et al, 2007;Rhim et al, 2008). It was meaningful that this method has been reported to be effective to keep enough space between the liver and the adjacent organs including the diaphragm by a solution that can cool down the local ablated area by circulating in the peritoneal space.…”

Section: The Purpose Of the Artificial Ascites Techniquementioning

confidence: 99%

Radiofrequency Ablation for Hepatocellular Carcinoma at the Dome of the Liver: A Review

Mochizuki¹

2012

Hepatocellular Carcinoma - Clinical Research

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Percutaneous Radiofrequency Ablation with Artificial Ascites for Hepatocellular Carcinoma in the Hepatic Dome: Initial Experience

Abstract: Percutaneous radiofrequency ablation with artificial ascites appears a feasible, safe, and effective technique for treating HCC of the hepatic dome.

Cited by 135 publications

References 35 publications

Design and validation of a thermoreversible material for percutaneous tissue hydrodissection

Design and validation of a thermoreversible material for percutaneous tissue hydrodissection

Radiofrequency ablation: technique and clinical applications

Radiofrequency Ablation for Hepatocellular Carcinoma at the Dome of the Liver: A Review

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