title: Hepatocellular carcinoma and liver metastases: clinical data on a new dual-lumen catheter kit for surgical sealant infusion to prevent perihepatic bleeding and dissemination of cancer cells following biopsy and loco-regional treatments.
abstract: BACKGROUND
  RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications. The most common reported complications include abdominal hemorrhage, bile leakage, biloma formation, hepatic abscesses, and neoplastic seeding. The aim of this study is to evaluate the feasibility of percutaneous use of surgical sealant with a new coaxial bilumen catheter, to prevent the perihepatic bleeding and dissemination of cancer cells through the needle-electrode (neoplastic seeding) or along the needle track.
  
  
  METHODS
  We designed a novel dual-lumen catheter to facilitate the optimal application of fibrin sealant after diagnostic and therapeutic percutaneous procedures. Percutaneous RFA has been performed using mask ventilation or neuroleptanalgesia. The main aims of this study, after the ablation procedure, in the treatment of unresectable liver cancer were to prevent major adverse events: a) the perihepatic bleeding; b) dissemination of cancer cells through the needle-electrode and or needle track.
  
  
  RESULTS
  A total of 181 patients were evaluated for this study at National Cancer Institute of Naples from January 2012 to January 2014. The association of blood loss (≤1 g/dl; ≥1 g/dl) with age, gender, histological diagnosis were analyzed. No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.
  
  
  CONCLUSIONS
  This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.
authors.affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Izzo
authors.affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Palaia
authors.affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Albino
authors.affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Amore
authors.affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Raimondo
authors.initials: R
authors.lastname: di Giacomo
authors.affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Piccirillo
authors.affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Leongito
authors.affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Aurelio
authors.initials: A
authors.lastname: Nasto
authors.affiliation: Radiology Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Granata
authors.affiliation: Radiology Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Petrillo
authors.affiliation: Nuclear Medicine Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.
authors.forename: Secondo
authors.initials: S
authors.lastname: Lastoria
keywords: Dual lumen catheter; Hepatocarcinoma; Liver metastases; Locoregional treatments; Sealant