title: Microwave ablation in the spleen versus partial splenic artery embolisation: A new technique for hypersplenism in cirrhosis.
abstract: OBJECTIVE
  Splenectomy has been associated with high perioperative morbidity and mortality. Partial splenic artery embolisation (PSE) was found to be an effective and safer method but with numerous complications. Local thermal ablative techniques such as microwave ablation (MWA) have been tried and were found to be safe and effective alternatives. This randomised controlled study aimed to compare the efficacy and safety of MWA versus PSE in the treatment of hypersplenism in patients with post-hepatitis C cirrhosis.
  
  
  METHODS
  In total, 40 patients with post-hepatitis C cirrhosis complicated with hypersplenism were randomised into two groups: Group I: 20 patients treated with percutaneous MWA of splenic parenchyma under ultrasound guidance and Group II: 20 patients treated with PSE using Embosphere.
  
  
  RESULTS
  There was a significant increase in haemoglobin levels in group I compared with group II after 3months of follow-up. However, White blood cell (WBC) count and platelets significantly increased more in group II than in group I after 1month. Postprocedure significant hyperbilirubinaemia, hypoalbuminaemia, decreased prothrombin concentration, and increased creatinine levels were encountered in group II only. There was a significant increase in postoperative complications in group II compared to group I, and a single case of mortality was reported in group II.
  
  
  CONCLUSIONS
  MWA and PSE were comparably effective; however, MWA was safer than PSE, which caused serious adverse events and mortality. MWA appears to be a good alternative for the treatment of hypersplenism in patients with cirrhosis and portal hypertension.
authors.affiliation: Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Fathia
authors.initials: F
authors.lastname: Assal
authors.affiliation: Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt. Electronic address: m_elkassas@yahoo.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Kassas
authors.affiliation: Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Eslam
authors.initials: E
authors.lastname: Esmail
authors.affiliation: Radiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Amr A
authors.initials: AA
authors.lastname: Elbadry
authors.affiliation: Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Sabry
authors.initials: S
authors.lastname: Abousaif
authors.affiliation: Internal Medicine Department, Assiut University, Assiut, Egypt.
authors.forename: Reem
authors.initials: R
authors.lastname: Mahdy
authors.affiliation: Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Asem
authors.initials: A
authors.lastname: Elfert
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000792:Angiography; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006971:Hypersplenism / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D013157:Splenic Artery; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Hypersplenism; Microwave ablation; Partial splenic artery embolisation