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233例肝肿瘤射频消融术后的并发症

Complications after Radiofrequency Ablation of 233 Hepatic Tumors.

作者信息

Fonseca Alexandre Zanchenko, Saad William Abrao, Ribeiro Marcelo Augusto

机构信息

Department of General Surgery, University of Santo Amaro, Sx00E3;o Paulo, Brazil.

出版信息

Oncology. 2015;89(6):332-6. doi: 10.1159/000439089. Epub 2015 Sep 30.

Abstract

OBJECTIVE

The only curative treatment for primary and secondary hepatic malignancies is surgery and liver transplantation. Thus, the majority of the patients are not candidates for resection, and there is a lack of organs. For these reasons, alternative treatment modalities such as radiofrequency ablation (RFA) are employed. The objective of this paper is to evaluate the incidence and types of complications related to open and percutaneous RFA.

METHOD

This is a retrospective study of patients with hepatic malignancies treated by RFA. Tumor size, location, numbers of nodules, approach, histology and associated procedures were analyzed and correlated to complications.

RESULTS

A total of 151 patients with primary and secondary hepatic malignancies were included: 58 with hepatocellular carcinoma (HCC), 68 with metastases from colorectal cancer and 25 with other types of tumors. Complications occurred in 24.5% of the patients, mostly (58.9%) in those with HCC. Ascites was the most common complication, followed by wound infection. The only two significant factors associated with complications were the presence of HCC (p = 0.0087) and two or more lesions (p = 0.0323). The mortality rate was 0.69%.

CONCLUSION

RFA is a safe technique, but complications may occur and are multifactorial. Appropriate patient selection, early complication recognition and adequate treatment are essential.

摘要

目的

原发性和继发性肝恶性肿瘤的唯一根治性治疗方法是手术和肝移植。因此,大多数患者不适合进行切除手术,且器官供体短缺。基于这些原因,人们采用了诸如射频消融(RFA)等替代治疗方式。本文的目的是评估与开放式和经皮RFA相关的并发症的发生率和类型。

方法

这是一项对接受RFA治疗的肝恶性肿瘤患者的回顾性研究。分析肿瘤大小、位置、结节数量、治疗方法、组织学和相关操作,并将其与并发症进行关联分析。

结果

共纳入151例原发性和继发性肝恶性肿瘤患者:58例为肝细胞癌(HCC),68例为结直肠癌转移瘤,25例为其他类型肿瘤。24.5%的患者发生了并发症,其中大多数(58.9%)为HCC患者。腹水是最常见的并发症,其次是伤口感染。与并发症相关的仅有的两个显著因素是HCC的存在(p = 0.0087)和两个或更多病灶(p = 0.0323)。死亡率为0.69%。

结论

RFA是一种安全的技术,但可能会发生并发症,且并发症是多因素导致的。合适的患者选择、早期并发症识别和充分治疗至关重要。

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