title: Safety of hydroinfusion in percutaneous thermal ablation of hepatic malignancies.
abstract: OBJECTIVE
  Hydroinfusion is a commonly used ancillary procedure during percutaneous thermal ablation of the liver that is used to separate and protect sensitive structures from the ablation zone. However, risks of hydroinfusion have not been systematically studied. The purpose of the present study was to systematically examine the frequency and severity of local and systemic complications related to hydroinfusion.
  
  
  METHODS
  From January 2009 to April 2012, 410 consecutive patients underwent percutaneous thermal hepatic tumor ablation. One hundred fifty patients in the study group underwent hydroinfusion and 260 in the control group did not. Patient charts and imaging studies of both groups were reviewed to compare incidences of complications that could potentially be caused by hydroinfusion, including pleural effusion, bowel injury, infection, electrolyte imbalance, and hyperglycemia.
  
  
  RESULTS
  Pleural effusions were found to occur more commonly in the hydroinfusion group (45.3%) than in the control group (16.5%). Pleural effusions were significantly larger (P < .001) and more likely to be symptomatic (six of 150 patients; P = .006) in the hydroinfusion group than in the control group (one of 260 patients). Multiple patient and tumor characteristics were analyzed for association with development of major hydroinfusion-type complications (requiring therapy or extended/repeat hospitalization). Subcapsular location of tumor was the only variable to reach statistical significance (P = .009), with all major hydroinfusion-type complications (n = 10) occurring in patients with subcapsular tumors.
  
  
  CONCLUSIONS
  Hydroinfusion is a safe procedure overall. However, pleural effusions occur commonly after hydroinfusion, tend to be moderate or large in size, and are occasionally symptomatic.
authors.affiliation: Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, 2nd Floor, Suite 2125, Los Angeles, CA 90095. Electronic address: jumcwilliams@mednet.ucla.edu.
authors.forename: Justin P
authors.initials: JP
authors.lastname: McWilliams
authors.affiliation: Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, 2nd Floor, Suite 2125, Los Angeles, CA 90095.
authors.forename: Adam N
authors.initials: AN
authors.lastname: Plotnik
authors.affiliation: Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, 2nd Floor, Suite 2125, Los Angeles, CA 90095.
authors.forename: Eric Y
authors.initials: EY
authors.lastname: Sako
authors.affiliation: Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, 2nd Floor, Suite 2125, Los Angeles, CA 90095.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Raman
authors.affiliation: Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, 2nd Floor, Suite 2125, Los Angeles, CA 90095.
authors.forename: Nelly
authors.initials: N
authors.lastname: Tan
authors.affiliation: Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, 2nd Floor, Suite 2125, Los Angeles, CA 90095.
authors.forename: Surachate
authors.initials: S
authors.lastname: Siripongsakun
authors.affiliation: Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, 2nd Floor, Suite 2125, Los Angeles, CA 90095.
authors.forename: Michael
authors.initials: M
authors.lastname: Douek
authors.affiliation: Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, 757 Westwood Plaza, 2nd Floor, Suite 2125, Los Angeles, CA 90095.
authors.forename: David S
authors.initials: DS
authors.lastname: Lu
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D005947:Glucose / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007263:Infusions, Parenteral; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005947:Glucose