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2084次肝脏肿瘤热消融术后主要并发症的发生率及危险因素

The frequency and risk factors of major complications after thermal ablation of liver tumours in 2,084 ablation sessions.

作者信息

Huang Qiannan, Pang Mengya, Zeng Qingjing, He Xuqi, Zheng Rongqin, Ge Mian, Li Kai

机构信息

Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Front Surg. 2022 Sep 15;9:1010043. doi: 10.3389/fsurg.2022.1010043. eCollection 2022.

Abstract

BACKGROUND

To assess the frequency of major complications after thermal ablation of liver tumours and to determine risk factors for adverse events.

METHODS

A retrospective study was conducted between January 2015 and January 2021. A total of 2,084 thermal ablation sessions in 1,592 patients with primary and metastatic liver tumours were evaluated. The frequency of major complications was evaluated according to the Society of Interventional Radiology Standards, and putative predictors of adverse events were analysed using simple and multivariate logistic regression.

RESULTS

Thermal ablation-related mortality was 0.1% (2/2,084), with an overall major complication rate of 5.6% (117/2,084). The most frequent major complication was symptomatic pleural effusion (2.9%, 60/2,084). Multivariate logistic regression analysis revealed that a total maximum diameter of lesions >3 cm, microwave ablation (MWA) and MWA combined with radiofrequency ablation, intrahepatic cholangiocarcinoma and postoperative systemic inflammatory response syndrome were independent prognostic factors for major complications.

CONCLUSIONS

Thermal ablation of liver tumours is a safe procedure with an acceptable incidence of major complications. The risk factors identified in this study will help to stratify high-risk patients.

摘要

背景

评估肝肿瘤热消融术后主要并发症的发生率,并确定不良事件的危险因素。

方法

进行一项回顾性研究,时间跨度为2015年1月至2021年1月。共评估了1592例原发性和转移性肝肿瘤患者的2084次热消融治疗。根据介入放射学会标准评估主要并发症的发生率,并使用单因素和多因素逻辑回归分析不良事件的假定预测因素。

结果

热消融相关死亡率为0.1%(2/2084),总体主要并发症发生率为5.6%(117/2084)。最常见的主要并发症是有症状的胸腔积液(2.9%,60/2084)。多因素逻辑回归分析显示,病变总最大直径>3 cm、微波消融(MWA)以及MWA联合射频消融、肝内胆管癌和术后全身炎症反应综合征是主要并发症的独立预后因素。

结论

肝肿瘤热消融是一种安全的治疗方法,主要并发症发生率可接受。本研究确定的危险因素将有助于对高危患者进行分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d5e/9520062/db50f5f36ba3/fsurg-09-1010043-g001.jpg

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