A Critical Analysis of Postoperative Morbidity and Mortality After Laparoscopic Radiofrequency Ablation of Liver Tumors

Birsen, Onur; Aliyev, Shamil; Aksoy, Erol; Taşkın, Halit Eren; Akyüz, Muhammet; Karabulut, Koray; Siperstein, Allan; Berber, Eren

doi:10.1245/s10434-014-3526-8

Cited by 12 publications

(7 citation statements)

References 40 publications

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“…The safety of VLA for HCC had so far been reported for series of no more than 267 patients treated with RFA, and 203 treated with MWA . The vast majority of the complications described to date (in 2% to 45% of patients treated with VL RFA, and in 16% to 62% of those treated with VL MWA) were minor. The use of MWA has nonetheless been widely questioned because of the potentially higher risk of major biliary damage associated with the greater amount of energy delivered.…”

Section: Discussionmentioning

confidence: 99%

Videolaparoscopic microwave ablation in patients with HCC at a European high‐volume center: Results of 815 procedures

Cillo

Bertacco

Fasolo

et al. 2019

Journal of Surgical Oncology

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Background: Videolaparoscopic (VL) microwave ablation (MWA) is not included in most of the international guidelines as a therapeutic option for hepatocellular carcinoma (HCC). Aim of this study was to assess the safety of VL MWA in patients with HCC for whom resection or percutaneous ablation is unsuitable. Methods: A retrospective analysis was performed on a prospective database of patients with HCC treated with VL MWA at our institution from 2009 to 2016. Patient demographics, operational characteristics, and complications were recorded. Statistical analysis was performed to identify safety profile, overall survival and recurrence rate. Results: A total of 815 VL MWA were performed in 674 patients with a mean age of 64 years. Patients had a mean Model for End‐stage Liver Disease score of 10 (±3); 32.8% were Child B, 44.1% Barcelona Clinic Liver Cancer B‐C. Perioperative mortality was 0.4%. Overall morbidity was 30.8%, with Dindo‐Clavien complications ≥3 in 2%. The median length of stay was 2 days. In 43.1% VL MWA was the first‐line therapy. Overall 1‐, 3‐, and 5‐year survival rates were 81.9%, 54.9%, and 35.9%. Conclusions: The present is the largest series of VL ablation and the bigger number of patients with HCC treated with MW reported nowadays. It confirms the safety of a minimally invasive procedure for patients with HCC when resection or percutaneous ablation is not feasible.

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Section: Discussionmentioning

confidence: 99%

Videolaparoscopic microwave ablation in patients with HCC at a European high‐volume center: Results of 815 procedures

Cillo

Bertacco

Fasolo

et al. 2019

Journal of Surgical Oncology

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“…Birsen et al [9] analyzed the 90-day morbidity and mortality of 910 patients who underwent a total of 1,207 laparoscopic RFA procedures for 2,890 malignant liver tumors between 1996 and 2012. In this large study, they found that laparoscopic RFA was associated with a complication rate of 4% (n = 50) and a mortality of 0.4% (n = 5).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of laparoscopic radiofrequency ablation of single primary or recurrent hepatocellular carcinoma (≤3 cm)

Kim

et al. 2017

Ann Surg Treat Res

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PurposePercutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) has some limitations such as poor sonic window and injury to adjacent organs. The laparoscopic approach has been suggested as an alternative option. The aim of this study was to show the safety and efficacy of laparoscopic RFA for single, small (≤3 cm), and primary or recurrent HCC that is not suitable for percutaneous RFA or surgical resection.MethodsWe reviewed the cases of 37 patients (32 men and 5 women, mean age 61 ± 8.1 years) who underwent laparoscopic RFA for single, small HCC (≤3 cm) that was unsuitable for percutaneous RFA or surgical resection.ResultsThe technical success rate was 94.6% and 34 patients (95%) had no complications. There were no conversions to open RFA and no operative mortality. The primary effectiveness rate 1 month after the procedure was 100%. The overall recurrence rates at 3, 6, 12, and 24 months after the laparoscopic RFA were 8.1%, 14.4%, 25%, and 35.7%, respectively. The local tumor progression rate was 4.2% at 6 months and 8.7% at 9 months.ConclusionLaparoscopic RFA is a safe and effective treatment for HCC cases that are unsuitable for percutaneous RFA.

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“…In terms of the implementation of RFA under ultrasonic labeling in the treatment of patients with HCC disease, previous findings have confirmed that this method has many advantages such as no radiation on the human body, simple operation, and the ability to observe lesions in real time. However, in contrast to an ultrasonic image cannot be formed due to small liver lesions, no vessel violations and iso-echoic HCC, ordinary ultrasound labeling is inadequate as it is difficult to accurately locate the cancer tissue ( 16 – 18 ). Consequently, during the treatment of HCC by RFA, CEUS technology should be employed as it enhances image sharpness and contrast, detects enhanced blood flow data and the lesion infiltration range, which cannot be identified by ordinary ultrasound, thereby indicating the efficacy for more thorough treatment by RFA.…”

Section: Discussionmentioning

confidence: 99%

The clinical effect and relevant mechanism of combined sorafenib and radiofrequency ablation in the treatment of early small hepatocellular carcinoma

et al. 2016

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The number of cases with hepatocellular carcinoma (HCC) are on the increase. The aim of the present study was to investigate the clinical effect and relevant mechanism of combined sorafenib and radiofrequency ablation (RFA) in the treatment of the early small HCC. A total of 120 cases of patients with small HCC that presented during the period of May 2007 to June 2010 were selected and divided into the surgery (n=60) and RF (n=60) groups according to the treatment method employed. The surgery group was treated with a laparotomy resection and the RF group was treated with combined sorafenib and RFA, and a comparative analysis was made between the two groups with regard to recurrence rates, adverse reactions, and survival rates. After treatment of 1 month, the radical effective rate of the surgery and RF groups was 100%. Contrast-enhanced ultrasound images of the patients in the RF group were taken. During the 5-year follow-up, the tumor recurrence rate in the surgery group was 18.3%, significantly lower than that in the RF group where the tumor recurrence rate was 38.3% (P<0.05). The occurrence rate of postoperative pain, fever, abdominal bleeding, infection, and other complications of patients in the surgery group was significantly higher than the complication occurrence rate (P<0.05) of the patients in the RF group. The average survival time of the patients in the surgery group was 51.2±1.5 months and the survival rates during the first, third and fifth year were 90.7, 71.5 and 56.7%, respectively. Additionally, the average survival time of the patients in the RF group was 64.6±2.4 months and the survival rates during the first, third and fifth year were 91.1, 72.8 and 57.5%, respectively. The difference between the two groups was not statistically significant. The tumor-free survival rates in the surgery group during the first, third and fifth year were 87.8, 44.3 and 33.2%, respectively, while the tumor-free survival rates in the RF group during the first, third and fifth year were 86.2, 48.3 and 34.6%, respectively, and the difference between the two groups was not statistically significant. In conclusion, the combined sorafenib and RFA method, and laparotomy resection method have their advantages in the treatment of early small HCC, and under specific medical conditions, the former can partially replace the latter and be used as a preferred treatment means in the treatment of early small HCC.

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A Critical Analysis of Postoperative Morbidity and Mortality After Laparoscopic Radiofrequency Ablation of Liver Tumors

Cited by 12 publications

References 40 publications

Videolaparoscopic microwave ablation in patients with HCC at a European high‐volume center: Results of 815 procedures

Videolaparoscopic microwave ablation in patients with HCC at a European high‐volume center: Results of 815 procedures

Clinical outcomes of laparoscopic radiofrequency ablation of single primary or recurrent hepatocellular carcinoma (≤3 cm)

The clinical effect and relevant mechanism of combined sorafenib and radiofrequency ablation in the treatment of early small hepatocellular carcinoma

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