肝肿瘤射频消融的并发症

Complications of radiofrequency coagulation of liver tumours.

作者信息

Mulier S, Mulier P, Ni Y, Miao Y, Dupas B, Marchal G, De Wever I, Michel L

机构信息

Department of General Surgery, University Hospital Mont-Godinne, Catholic University of Louvain, Belgium.

出版信息

Br J Surg. 2002 Oct;89(10):1206-22. doi: 10.1046/j.1365-2168.2002.02168.x.

DOI:10.1046/j.1365-2168.2002.02168.x

PMID:12296886

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.

METHODS

This is an exhaustive review of the world literature (articles and abstracts) up to 31 December 2001; 82 independent reports of RFC of liver tumours were analysed.

RESULTS

In total, 3670 patients were treated with percutaneous, laparoscopic or open RFC. The mortality rate was 0.5 per cent. Complications occurred in 8.9 per cent: abdominal bleeding in 1.6 per cent, abdominal infection in 1.1 per cent, biliary tract damage in 1.0 per cent, liver failure in 0.8 per cent, pulmonary complications in 0.8 per cent, dispersive pad skin burn in 0.6 per cent, hepatic vascular damage in 0.6 per cent, visceral damage in 0.5 per cent, cardiac complications in 0.4 per cent, myoglobinaemia or myoglobinuria in 0.2 per cent, renal failure in 0.1 per cent, tumour seeding in 0.2 per cent, coagulopathy in 0.2 per cent, and hormonal complications in 0.1 per cent. The complication rate was 7.2, 9.5, 9.9 and 31.8 per cent after a percutaneous, laparoscopic, simple open and combined open approach respectively. The mortality rate was 0.5, 0, 0 and 4.5 per cent respectively.

CONCLUSION

The morbidity and mortality of RFC, while low, is higher than previously assumed. With adequate knowledge, many complications are preventable.

摘要

背景

射频凝固术（RFC）作为一种治疗肝肿瘤的发病率较低的新技术正在得到推广。本研究的目的是严格评估在经验丰富和经验有限的中心中RFC的并发症发生率，并确定其原因以及预防和治疗的可能方法。

方法

这是一项对截至2001年12月31日的世界文献（文章和摘要）的详尽综述；分析了82篇关于肝肿瘤RFC的独立报告。

结果

共有3670例患者接受了经皮、腹腔镜或开放式RFC治疗。死亡率为0.5%。并发症发生率为8.9%：腹部出血1.6%，腹部感染1.1%，胆道损伤1.0%，肝衰竭0.8%，肺部并发症0.8%，分散电极片皮肤灼伤0.6%，肝血管损伤0.6%，内脏损伤0.5%，心脏并发症0.4%，肌红蛋白血症或肌红蛋白尿0.2%，肾衰竭0.1%，肿瘤种植0.2%，凝血病0.2%，激素并发症0.1%。经皮、腹腔镜、单纯开放和联合开放治疗后并发症发生率分别为7.2%、9.5%、9.9%和31.8%。死亡率分别为0.5%、0、0和4.5%。