Hyaluronic acid gel injection to prevent thermal injury of adjacent gastrointestinal tract during percutaneous liver radiofrequency ablation.
This study evaluated the safety, feasibility, and clinical utility of hyaluronic acid gel injection to separate the gastrointestinal tract from the tumor during liver radiofrequency ablation (RFA). Eleven patients with liver tumors measuring 0.9-3.5 cm (mean ± standard deviation, 2.1 ± 0.8 cm) that were adjacent to the gastrointestinal tracts received RFA after the mixture of hyaluronic acid gel and contrast material (volume, 26.4 ± 14.5 mL; range, 10-60 mL) was injected between the tumor and the gastrointestinal tract under computed tomographic-fluoroscopic guidance. Each tumor was separated from the gastrointestinal tract by 1.0-1.5 cm (distance, 1.2 ± 0.2 cm) after injection of hyaluronic acid gel, and subsequent RFA was performed without any complications in all patients. Although tumor enhancement disappeared in all patients, local tumor progression was found in a patient (9.1%, 1 of 11) during the follow-up of 5.5 ± 3.2 months (range, 0.4-9.9 months). In conclusion, hyaluronic acid gel injection is a safe and useful technique to avoid thermal injury of the adjacent gastrointestinal tract during liver RFA.
Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. hasegawat@clin.medic.mie-u.ac.jp
Takaaki
T
Hasegawa
Haruyuki
H
Takaki
Hideki
H
Miyagi
Atsuhiro
A
Nakatsuka
Junji
J
Uraki
Takashi
T
Yamanaka
Masashi
M
Fujimori
Hajime
H
Sakuma
Koichiro
K
Yamakado
D000368:Aged; D000369:Aged, 80 and over; D002058:Burns, Electric / Q000517:prevention & control*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005782:Gels / Q000494:pharmacology; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology*; D015552:Injections, Intralesional; D007430:Intraoperative Care / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011446:Prospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D041742:Upper Gastrointestinal Tract / Q000293:injuries
D005782:Gels; D006820:Hyaluronic Acid