title: Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors.
abstract: Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe. Thus, complications occur and vary widely in the literature. Complications are caused by thermal damage, direct needle injury, infection and the patient's co-morbidities. Tumor type, type of approach, number of lesions, tumor localization, underlying hepatic disease, the physician's experience, associated hepatic resection and lesion size have been described as factors significantly associated with complications. The physician in charge should promptly recognize high-risk patients more susceptible to complications, perform a close post procedure follow-up and manage them early and adequately if they occur. We aim to describe complications from RFA of hepatic tumors and their risk factors, as well as a few techniques to avoid them. This way, others can decrease their morbidity rates with better outcomes.
authors.affiliation: Alexandre Zanchenko Fonseca, Stephanie Santin, Marcelo Augusto Fontenelle Ribeiro Jr., Department of General Surgery, University of Santo Amaro, São Paulo, SP CEP 04702-001, Brazil.
authors.forename: Alexandre Zanchenko
authors.initials: AZ
authors.lastname: Fonseca
authors.affiliation: Alexandre Zanchenko Fonseca, Stephanie Santin, Marcelo Augusto Fontenelle Ribeiro Jr., Department of General Surgery, University of Santo Amaro, São Paulo, SP CEP 04702-001, Brazil.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Santin
authors.affiliation: Alexandre Zanchenko Fonseca, Stephanie Santin, Marcelo Augusto Fontenelle Ribeiro Jr., Department of General Surgery, University of Santo Amaro, São Paulo, SP CEP 04702-001, Brazil.
authors.forename: Luiz Guilherme Lisboa
authors.initials: LG
authors.lastname: Gomes
authors.affiliation: Alexandre Zanchenko Fonseca, Stephanie Santin, Marcelo Augusto Fontenelle Ribeiro Jr., Department of General Surgery, University of Santo Amaro, São Paulo, SP CEP 04702-001, Brazil.
authors.forename: Jaques
authors.initials: J
authors.lastname: Waisberg
authors.affiliation: Alexandre Zanchenko Fonseca, Stephanie Santin, Marcelo Augusto Fontenelle Ribeiro Jr., Department of General Surgery, University of Santo Amaro, São Paulo, SP CEP 04702-001, Brazil.
authors.forename: Marcelo Augusto Fontenelle
authors.initials: MA
authors.lastname: Ribeiro
keywords: Complications; Hepatic tumors; Hepatocellular carcinoma; Radiofrequency ablation; Risk factors