Han Yue, Hao Yu-zhi, Cai Jian-qiang, Yang Min, Liu Shan, He Lian-fang, Yu Lei, Chen Min-hua
Department of Radiofrequency Ablation, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
Zhonghua Gan Zang Bing Za Zhi. 2012 Apr;20(4):266-9. doi: 10.3760/cma.j.issn.1007-3418.2012.04.008.
To assess the value of an infusion-based separation technique to assist in ultrasound (US)-guided percutaneous radiofrequency ablation (RFA) of liver cancers abutting the liver edge.
Twenty-four cases of malignant liver tumors abutting the hepatic edge were treated with US-guided puncture accompanied by the assistant infusion technique. The US-guided puncture was made with a 22-G needle through the hepatic tissue and into the abdominal cavity near the target tumor. Infusion of a saline solution was used to separate the liver from any surrounding structures so that percutaneous RFA could be safely performed. Complications, including gastrointestinal injury, hemorrhage and death, were recorded. Technical efficacy and safety were evaluated.
Among the 24 patients, the target tumors were adjacent to the right kidney (n=6), colon (n=6), stomach (n=5), pericardium (n=4), and gall bladder (n=3). Twenty-three patients received a successful radical percutaneous RFA with assistant infusion. The assistant infusion volumes ranged from 80-390 ml and created spaces ranging from 0.8-2.5 cm between the liver and surrounding structures. Five of the cases with tumors adjacent to the stomach or colon received the largest volume infusions. The infusion failed to create a separation space in only one case, due to the presence of an adhesion; as a result, this patient was treated with palliative RFA. The mean hospital stay for all 24 patients was four days after surgery. No severe complications or deaths occurred. At 1-month follow-up, computed tomography images showed that 22 cases had complete ablation, yielding a technical success rate of 95.7% (22/23). No needle track implantation was observed.
Assistant infusion for percutaneous radiofrequency ablation creates a protective space between the liver and surrounding structures in patients with liver tumors abutting the liver edge. This safe and effective assistant technique broadens the range of patients available for percutaneous RFA treatment.
评估一种基于输注的分离技术在超声（US）引导下对临近肝边缘的肝癌进行经皮射频消融（RFA）中的价值。
24例临近肝边缘的恶性肝肿瘤患者接受了超声引导下穿刺并辅以输注技术。使用22G穿刺针在超声引导下经肝组织穿刺进入目标肿瘤附近的腹腔。输注生理盐水以分离肝脏与周围结构，从而能够安全地进行经皮RFA。记录包括胃肠道损伤、出血和死亡在内的并发症。评估技术疗效和安全性。
24例患者中，目标肿瘤分别毗邻右肾（n = 6）、结肠（n = 6）、胃（n = 5）、心包（n = 4）和胆囊（n = 3）。23例患者在辅助输注下成功进行了根治性经皮RFA。辅助输注量为80 - 390 ml，在肝脏与周围结构之间形成了0.8 - 2.5 cm的间隙。5例肿瘤毗邻胃或结肠的患者接受了最大量的输注。仅1例因存在粘连，输注未能形成分离间隙，该患者接受了姑息性RFA治疗。所有24例患者术后平均住院时间为4天。未发生严重并发症或死亡。1个月随访时，计算机断层扫描图像显示22例完全消融，技术成功率为95.7%（22/23）。未观察到针道种植。
对于临近肝边缘的肝肿瘤患者，经皮射频消融辅助输注可在肝脏与周围结构之间创建一个保护间隙。这种安全有效的辅助技术拓宽了可进行经皮RFA治疗的患者范围。
