Percutaneous radiofrequency ablation of pulmonary tumors--is there a difference between treatment under general anaesthesia and under conscious sedation?
OBJECTIVE
This retrospective study aimed to compare feasibility, complication rate and local tumor control after radiofrequency ablation (RFA) of pulmonary tumors under conscious analgo-sedation (AS) versus general anaesthesia (GA).


METHODS
Within 36 months 21 patients had RFA (36 tumors, 26 treatment sessions). One patient suffered from NSCLC, 20 had metastases (breast (8/20), colorectal (6/20), renal cell (2/20), pharyngeal carcinoma (1/20), malignant melanoma (3/20)). Patients were no surgical candidates due to underlying comorbidities. Eleven of 26 treatments were performed under GA, while in 15 of 26 treatments AS was used. Follow-up was scheduled 24 h, 6 weeks, 3 months, 6 months and then every 6 months after treatment.


RESULTS
RFA was feasible in all treatments under GA, while under AS targeting of the lesion was not possible in 2/15. Six adverse events occurred in the GA group (three major, three minor), while seven complications happened in the AS group (three major, four minor) (p=0.57). During follow-up of 3-36 months local recurrence was detected in 3 of 21 tumors in the GA group and in 2 of 15 tumors in the AS group (p=0.79).


CONCLUSIONS
Hospitalization, complication rates and types, and the rate of local tumor control did not differ substantially among both groups. Furthermore, there was no significant difference in technical success and feasibility.


CONCLUSIONS
RFA of pulmonary tumors under GA or AS did not result in different tumor control and complication rates, respectively. Therefore, AS should be used except in anxious or agitated patients.
Hoffmann
R T
RT
Institute of Clinical Radiology, Ludwig-Maximilians-University, Campus Grosshadern, Marchioninstr, 15, 81377 Munich, Germany. rthoffma@med.uni-muenchen.de
Jakobs
T F
TF
Lubienski
A
A
Schrader
A
A
Trumm
C
C
Reiser
M F
MF
Helmberger
T K
TK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D017115:Catheter Ablation / Q000379:methods*; D016292:Procedural Sedation; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome