Zhang Q, Li X, Pan J, Wang Z
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Indian J Cancer. 2015 Dec;52 Suppl 2:e64-8. doi: 10.4103/0019-509X.172516.
Neoplasm abutting the diaphragm is one kind of the special sites of liver neoplasms treated with radiofrequency ablation (RFA), the purpose of this study is to evaluate the feasibility and safety of computed tomography (CT)-guided RFA of liver neoplasms abutting the diaphragm with multiple bipolar electrodes sequentially passing through the lung parenchyma.
37 patients were treated with transpulmonary CT-guided RFA. Technical success rate, perioperative complications, and local tumor progression were investigated.
The number of electrode (s) sequentially passing through the lung parenchyma (NPLP) was 1 electrode in 20 patients, 2 electrodes in 14 cases, and 3 electrodes in 3 cases. Technical success rate was 100%. The most of the perioperative complications were self-limiting and mainly included pneumothorax (11 cases, 2 needed percutaneous drainage), hemorrhage of the electrode track in the lung parenchyma (6 cases), a small amount of hemoperitoneum in perihepatic space (8 cases) and discomfort of the right shoulder (7 cases). Local tumor progression occurred in 6 cases during the follow-up (3-12 months). Multivariate logistic regression analysis showed that the incidence of pneumothorax was not related to NPLP (P = 0.50), length of the electrode (s) in the lung parenchyma (P = 0.18), types of anesthesia (P = 0.10), and indwelling time of the electrode (s) in the lung parenchyma (P = 0.28).
CT-guided RFA of liver neoplasms abutting the diaphragm with multiple bipolar electrodes sequentially passing through the lung parenchyma is a feasible and safe therapeutic option.
紧邻膈肌的肿瘤是肝脏肿瘤射频消融（RFA）治疗的一类特殊部位，本研究旨在评估计算机断层扫描（CT）引导下多极双极电极依次穿过肺实质对紧邻膈肌的肝脏肿瘤进行RFA治疗的可行性和安全性。
对37例患者进行经肺CT引导下RFA治疗。研究技术成功率、围手术期并发症及局部肿瘤进展情况。
依次穿过肺实质的电极数量（NPLP）为：20例患者为1根电极，14例为2根电极，3例为3根电极。技术成功率为100%。大多数围手术期并发症为自限性，主要包括气胸（11例，2例需经皮引流）、肺实质内电极道出血（6例）、肝周间隙少量血腹（8例）及右肩部不适（7例）。随访期间（3 - 12个月）6例出现局部肿瘤进展。多因素逻辑回归分析显示，气胸发生率与NPLP（P = 0.50）、肺实质内电极长度（P = 0.18）、麻醉类型（P = 0.10）及肺实质内电极留置时间（P = 0.28）无关。
CT引导下多极双极电极依次穿过肺实质对紧邻膈肌的肝脏肿瘤进行RFA治疗是一种可行且安全的治疗选择。
