title: Radiofrequency ablation in the treatment of large hepatic hemangiomas: a comparison of multitined and internally cooled electrodes.
abstract: OBJECTIVE
  Radiofrequency (RF) ablation is an accepted nonsurgical treatment of hepatic hemangiomas, but with an appreciable complication rate. Our study aimed to assess the safety and efficacy of RF ablation, administered with either multitined expandable electrodes or with internally cooled cluster electrodes, in the treatment of large (≥10 cm diameter) hepatic hemangiomas.
  
  
  METHODS
  We retrospectively reviewed our sequential experience of treating 43 large hepatic hemangiomas in 42 patients with RF ablation/multitined expandable electrodes or with RF ablation/internally cooled electrodes. Twenty-two hemangiomas in 21 patients were treated with expandable electrode (multitined electrode group), and 21 hemangiomas in 21 patients were treated with internally cooled cluster electrode (internally cooled electrode group).
  
  
  RESULTS
  Among the 43 large hepatic hemangiomas, 27 subcapsular lesions were treated by a laparoscopic approach, and 16 lesions located in liver parenchyma were treated by a computed tomography-guided percutaneous approach. In the multitined electrode group, RF ablation treatment was performed in all 21 patients in 1 session. In the internally cooled electrode group, 18 patients were treated by RF ablation in 1 session, and 3 patients, with ≥14.0-cm single hemangioma, were treated with RF ablation in 2 sessions. Complete ablation was achieved in 81.8% (18/22) and 90.5% (19/21) in the multitined electrode group and the internally cooled electrode group, respectively (P>0.05). Ablation time for single hemangioma was shorter with the internally cooled electrode than with the multitined electrode (P<0.05). There were 79 complications related to ablation (2 major and 77 minor) in 31 patients. All 21 patients in the multitined electrode group experienced complications, compared with 10 of 21 patients (47.6%) in the internally cooled electrode group (P<0.05). Both of the 2 major complications occurred in the multitined electrode group. All the complications were treated successfully with conservative measures.
  
  
  CONCLUSIONS
  RF ablation is a safe and effective treatment for large hepatic hemangiomas. Use of the internally cooled cluster electrodes and a more defensive treatment algorithm can reduce the complications.
authors.affiliation: *Department of Hepatobiliary Surgery, Beijing Chao-yang Hospital Affiliated to Capital Medical University, Beijing †Department of General Surgery, Zhanhua People's Hospital §Department of Gastroenterology, Dezhou People's Hospital, Shandong ‡Department of General Surgery, Chaoyang Central Hospital, Liaoning, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Gao
authors.forename: Xuemei
authors.initials: X
authors.lastname: Ding
authors.forename: Shan
authors.initials: S
authors.lastname: Ke
authors.forename: Zonghai
authors.initials: Z
authors.lastname: Xin
authors.forename: Chunmin
authors.initials: C
authors.lastname: Ning
authors.forename: Qi
authors.initials: Q
authors.lastname: Sha
authors.forename: Wenbing
authors.initials: W
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D004867:Equipment Design; D005260:Female; D006391:Hemangioma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome