Liver ablation techniques: a review.
BACKGROUND
Ablation techniques for unresectable liver carcinomas have evolved immensely since their introduction. Results of studies involving these techniques are restricted to reports of patient case series, which are often not presented in a standardised manner. This review aims to summarise the major studies in ablation technologies and present them in a way that may make comparison between the major modalities easier.


METHODS
All major databases (Medline, Cochrane, Embase and Pubmed) were searched for studies using microwave, radiofrequency or cryoablation to treat unresectable liver tumours. Only studies with at least 30 patients and 3-year follow-up were included. Complication, recurrence and survival rates of all studies are summarised and presented.


CONCLUSIONS
It is difficult to compare ablation modalities, as probe design and energy sources have evolved rapidly over the last decade. Ablation offers an invaluable palliative option and in some cases it may offer rates of cure approaching that of surgical resection with lower morbidity and mortality. Perhaps the time has come, therefore, for prospective large-scale randomised control trials to take place comparing ablation modalities to each other and surgical resection.
Bhardwaj
N
N
Department of HPB surgery, Leicester Royal Infirmary, c/o Helen Southam, Mr DM Lloyd's Secretary Consultant HPB Surgeon, 6th Floor Balmoral Building, Leicester, UK. neilbhardwaj@yahoo.co.uk
Strickland
A D
AD
Ahmad
F
F
Dennison
A R
AR
Lloyd
D M
DM
D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms; D000075202:Contraindications; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004598:Electrosurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006406:Hematoma / Q000401:mortality / Q000601:surgery*; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008099:Liver / Q000601:surgery*; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology