[Percutaneous, laparoscopic and open surgical radiofrequency ablation of malignant liver lesions].
The growing clinical impact of radiofrequency ablation of liver lesions is reflected by a rapidly increasing number of published papers. Experimental work focuses on factors that reduce the variability of the ablation zone. The Pringle-maneuver plays a key role in this question from a surgeon's perspective. Large single center studies and a meta-analysis show a sharp rise in the rate of local recurrences for tumors larger 3 cm. An open surgical approach is significantly correlated to a low local recurrence rate. Bile duct lesions and intrahepatic abscesses are the most frequent complications. Intraductal bile duct cooling can prevent these complications. Three prospective randomized trials support the use of RFA for small hepatocellular carcinoma. The use of RFA in patients with multiple colorectal metastases is supported by single center studies showing a 3 year survival of > 35%. The favourable cost / benefit ratio will make RFA a part of future multimodal cancer therapy concepts.
Stippel
D L
DL
Klinik und Poliklinik für Visceral- und Gefässchirurgie, Universität zu Köln. Dirk.Stippel@uni-koeln.de
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000191:economics / Q000379:methods; D015179:Colorectal Neoplasms; D003362:Cost-Benefit Analysis; D005500:Follow-Up Studies; D010535:Laparoscopy; D008099:Liver / Q000473:pathology; D008100:Liver Abscess / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D015201:Meta-Analysis as Topic; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome