Percutaneous ultrasound-guided radiofrequency ablation of hepatocellular carcinoma with artificially induced pleural effusion and ascites.
BACKGROUND
Ultrasound-guided procedures are sometimes of limited use because the tumor is located under the diaphragm or near the surface of the liver. We investigated the safety and efficacy of radiofrequency ablation (RFA) with artificial pleural effusion and/or artificial ascites.


METHODS
Between January 2002 and May 2006, 43 lesions in 36 patients with hepatocellular carcinoma (HCC) were treated by RFA with artificial pleural effusion and/or artificial ascites.


RESULTS
Artificial pleural effusion allowed visualization of the whole tumor for 36 (83.7%) of the 43 lesions that were otherwise not detectable or poorly visible. Artificial ascites was also helpful in visualizing whole tumors that could not be visualized with only artificial pleural effusion. In all lesions, artificial pleural effusion and/or artificial ascites were helpful in performing percutaneous RFA. Artificial ascites was useful for creating a space between the liver's surface and the skin or diaphragm to avoid burns. Adverse effects after the induction of artificial pleural effusion included pneumonia in one patient and temporary atelectasis in another patient. Severe side effects were not observed. Complete necrosis after RFA was obtained in 43 (100%) of the 43 lesions. During a mean follow-up period of 31.8 +/- 5.8 months, local recurrence at the ablation site was found in none of the 43 lesions.


CONCLUSIONS
Percutaneous RFA with artificial pleural effusion and/or artificial ascites was a safe and useful treatment that resulted in good local control of HCC.
Uehara
Takahide
T
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Hirooka
Masashi
M
Ishida
Kiyotaka
K
Hiraoka
Atsushi
A
Kumagi
Teru
T
Kisaka
Yoshiyasu
Y
Hiasa
Yoichi
Y
Onji
Morikazu
M
D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000517:prevention & control; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007263:Infusions, Parenteral / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion; D025321:Surgery, Computer-Assisted; D018084:Ultrasonography, Interventional
D005947:Glucose