Wang Xiao-hui, Yu Jie, Liang Ping, Yu Xiao-ling, Cheng Zhi-gang, Han Zhi-yu, Liu Fang-yi
Department of Interventional Ultrasoud, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Zhong Liu Za Zhi. 2012 Dec;34(12):945-9. doi: 10.3760/cma.j.issn.0253-3766.2012.12.014.
To analyze the major complications of percutaneous cooled-tip microwave ablation for the treatment of primary liver cancer and the possible risk factors of severe complications in a series of 693 patients.
The clinicopathological data of 693 patients with primary liver cancer who underwent ultrasound-guided percutaneous cooled-tip microwave (MW) ablation in our hospital over the past 5 years were retrospectively analyzed, and the risk factors of severe complications were explored.
In a total of 693 patients with 898 primary liver tumors were treated and 1111 MW ablation sessions were performed. The mean diameter of tumors was (2.5 ± 1.2) cm and the range was 0.4 - 10.0 cm. Three deaths occurred in the peri-ablation period, including one case died of multiorgan failure, one case died of pulmonary embolism and one case died of hepatorenal syndrome. Major complications occurred in 27 (3.9%) patients, including 12 pleural effusion requiring thoracentesis (1.7%), 10 tumor seeding (1.4%), 3 liver abscess and empyema (0.4%), 1 hemorrhage requiring arterial embolization (0.1%), and 1 bile duct injury (0.1%). The Chi-square test results showed that the diameter of tumors, number of MW ablation sessions and histological type of tumor were significantly associated with the major complications rate (P < 0.05). The multiple variables 1ogistic regression analysis showed that only type of tumors was associated with the major complication rate (P < 0.05).
Results of this study confirm that cooled-tip MW ablation is a relatively low-risk and effective minimally invasive procedure for the treatment of primary liver cancer. Proper direction for the treatment of cholangiocarcinoma (ICC) patients as well as fewer ablated tumor numbers during one hospital stay may help minimize the major complication rate in patients with primary liver cancer treated by ultrasound-guided percutaneous cooled-tip microwave ablation.
分析693例原发性肝癌患者接受经皮冷循环微波消融治疗后的主要并发症，以及严重并发症的可能危险因素。
回顾性分析我院过去5年693例接受超声引导下经皮冷循环微波（MW）消融治疗的原发性肝癌患者的临床病理资料，探讨严重并发症的危险因素。
共治疗693例原发性肝癌患者898个肿瘤，进行了1111次MW消融治疗。肿瘤平均直径为（2.5±1.2）cm，范围为0.4 - 10.0 cm。消融围手术期发生3例死亡，其中1例死于多器官功能衰竭，1例死于肺栓塞，1例死于肝肾综合征。27例（3.9%）发生主要并发症，包括12例需胸腔穿刺的胸腔积液（1.7%）、10例肿瘤种植（1.4%）、3例肝脓肿和脓胸（0.4%）、1例需动脉栓塞的出血（0.1%）和1例胆管损伤（0.1%）。卡方检验结果显示，肿瘤直径、MW消融次数和肿瘤组织学类型与主要并发症发生率显著相关（P<0.05）。多变量logistic回归分析显示，仅肿瘤类型与主要并发症发生率相关（P<0.05）。
本研究结果证实，冷循环MW消融是一种治疗原发性肝癌相对低风险且有效的微创手术。对于胆管癌（ICC）患者进行合理的治疗指导，以及在一次住院期间减少消融肿瘤数量，可能有助于降低超声引导下经皮冷循环微波消融治疗原发性肝癌患者的主要并发症发生率。
