Learning objectives
To review the main complications in the percutaneous thermoablative treatment of liver tumors.
Establish action keys to avoid them and decrease morbidity and mortality.
Background
Thermoablative percutaneous radiofrecuency and microwaves (RF and MW) treatments are accepted as safe therapeutic methods with complete response rates very similar to surgery in lesions <2 cm.
However,
its use is generalized in lesions of increasing size,
which leads to increasingly demanding procedures that are not risk-free.
We analyzed the main complications,
especially when performing large hepatic ablations (hemorrhages,
infarctions,
vascular thrombosis,
biliary lesions,
visceral ( abdominal or thoracic) lesions,
bowel or stomach injuries,
infections and others of unclear origin and less reported as massive...
Findings and procedure details
Liver Ablation
The liver has been the most common target organ for ablative percutaneous treatment of both primary and secondary neoplasms.
The ablation of hepatic lesions from the beginning has been considered very safe with very low mortality rates and major complications; oscillating generally from 0.7 to 1.4%.
Some recent series says a slightly higher mortality rates of up to 2% (Wong et.
al.).
Causes of death includes bowel perforation,
portal vein thrombosis,
hepatic failure,
septic shock from peritonitis and massive hepatic hemorrhage or hepatic...
Conclusion
Percutaneous ablative treatments of liver lesions are increasingly used in larger lesions.
Secondary complications in large ablations are also more frequent.
Their knowledge allows us to avoid them by increasing the safety of the procedures.
References
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Nemcek AA.
Complications of radiofrequency ablation of neoplasms.
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Livraghi T,
Solbiati L,
Meloni MF,
Gazelle GS,
Halpern EF,
Goldberg SN.
Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study.
Radiology 2003;226(2):441–451
Rhim H,
Yoon KH,
Lee JM,
et al.
Major complications after radio-frequency thermal ablation of hepatic tumors: spectrum of imaging findings.
Radiographics 2003;23(1):123–134,
discussion 134–13...