Thermal ablation of hepatocellular carcinoma in patients with abnormal coagulation function

Huang, Qiannan; Xu, Erjiao; Tan, Lei; Zeng, Qingjing; Zheng, Rongqin; Li, Kai

doi:10.1080/02656736.2017.1390787

Cited by 10 publications

(14 citation statements)

References 34 publications

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“…According to the studies reported by Goto et al [10] and Huang et al [33], the incidence rates of bleeding complications were 1.5% (63/4133) and 6.0% (3/50), respectively, which were significantly lower than the 28.6% (22/77) in this study but were similar to the 1.0% (22/2240) total incidence of bleeding complications in our single center. This difference may be related to the inclusion criteria of this study.…”

Section: Discussionsupporting

confidence: 81%

Contrast-enhanced Ultrasound for Evaluation of Active Needle Tract Bleeding during Thermal Ablation of Liver Cancer

Ye¹,

Huang²,

Zeng³

et al. 2022

Advanced Ultrasound in Diagnosis and Therapy

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To investigate the accuracy of contrast-enhanced ultrasound (CEUS) in the diagnosis and localization of active needle-tract bleeding (ANTB) during thermal ablation for liver cancer. Methods:Between June 2013 and December 2018, liver cancer patients with poor coagulation function or suspected needle-tract bleeding during ablation were enrolled in the study. Conventional US and CEUS were applied to detect ANTB and the bleeding sites, and sequentially abdominal paracentesis drainage (APD) was used as the gold standard for the diagnosis of ANTB.Thermal ablation guided by conventional US or CEUS was used to stop the bleeding.Results: Among the 77 enrolled patients, 21 patients (27.3%, 21/77) had ANTB. In total, four (19.0%) and 21 (100%) cases of ANTB were diagnosed by colour Doppler US and CEUS, respectively. The sensitivity, specificity and accuracy of colour Doppler US for diagnosing ANTB were 19.0%, 100% and 77.6%, respectively. The sensitivity, specificity, and accuracy of CEUS for diagnosing ANTB were 100%, 100% and 100%, respectively. The sensitivity of CEUS to diagnose ANTB was significantly higher than that of colour Doppler US (P < 0.001). All cases of ANTB were arterial bleeding and were stopped by thermal ablation under the guidance of colour Doppler US or CEUS. Conclusion:Compared to colour Doppler US, CEUS could detect ANTB with significantly higher sensitivity and accurately guide needle-tract ablation during thermal ablation of liver cancer.

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Section: Discussionsupporting

confidence: 81%

Contrast-enhanced Ultrasound for Evaluation of Active Needle Tract Bleeding during Thermal Ablation of Liver Cancer

Ye¹,

Huang²,

Zeng³

et al. 2022

Advanced Ultrasound in Diagnosis and Therapy

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show abstract

“…Bleeding and tumor seeding were not observed in this study. Cauterizing the needle track when withdrawing the electrode or antenna may help to prevent these complications [32]. As in previous reports, residual ascites disappeared spontaneously without additional diuretics or paracentesis.…”

Section: Discussionsupporting

confidence: 65%

Value of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery

Huang

Zeng

et al. 2020

BMC Cancer

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Background: To evaluate the feasibility and effectiveness of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery. Methods: Thirty-nine patients with a total of 40 liver malignant tumors were enrolled between January 2016 and June 2019. All had histories of hepatectomy, splenectomy, cholecystectomy, and intestinal surgery. The distance between the tumor and the gastrointestinal tract was < 5 mm. Normal saline was used as artificial ascites to protect the gastrointestinal tract during thermal ablation. The success rate of the procedure, incidence of major complications, and the technical efficacy of ablation were recorded. Patients were followed for local tumor progression (LTP), and overall survival (OS). Results: The use of artificial ascites was successful in 38 of the 40 procedures (95%). Major complications occurred in two of the 39 patients (5.1%) following the procedure. One was an intestinal fistula that occurred in a failed case and was associated with an infection. The other was a liver abscess that occurred in a successful case. The technical efficacy of ablation was 100% (40/40 procedures). The median follow-up was 16 months. The 1-, 2-, and 3-year LTP rates were 2.9, 5.7 and 5.7%. The 1-, 2-, and 3-year OS rates were 97.1, 86.8 and 69.5%. Conclusion: In patients with previous abdominal surgery, artificial ascites is feasible and effective for assisting thermal ablation of liver cancer adjacent to the gastrointestinal tract.

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“…Bleeding and tumor seeding were not observed in this study. Cauterizing the needle track when withdrawing the electrode or antenna may help to prevent these complications [30]. As in previous reports, residual ascites disappeared spontaneously without additional diuretics or paracentesis.…”

Section: Discussionsupporting

confidence: 65%

Value of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery

Huang

Zeng

et al. 2020

Preprint

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BackgroundTo evaluate the feasibility and effectiveness of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery.MethodsThirty-nine patients with a total of 40 liver malignant tumors were enrolled between January 2016 and June 2019. All had histories of hepatectomy, splenectomy, cholecystectomy, and intestinal surgery. The distance between the tumor and the gastrointestinal tract was < 5 mm. Normal saline was used as artificial ascites to protect the gastrointestinal tract during thermal ablation. The success rate of the procedure, incidence of major complications, and the technical efficacy of ablation were recorded. Patients were followed for local tumor progression (LTP), and overall survival (OS).ResultsThe use of artificial ascites was successful in 38 of the 40 procedures (95%). Major complications occurred in two of the 39 patients (5.1%) following the procedure. One was an intestinal fistula that occurred in a failed case and was associated with an infection. The other was a liver abscess that occurred in a successful case. The technical efficacy of ablation was 100% (40/40 procedures). The median follow-up was 20 months. The 1-, 2-, and 3-year LTP rates were 2.9%, 5.7% and 5.7%. The 1-, 2-, and 3-year OS rates were 97.1%, 86.8% and 69.5%.ConclusionIn patients with previous abdominal surgery, artificial ascites is feasible and effective for assisting thermal ablation of liver cancer adjacent to the gastrointestinal tract.Co-first authors: Qiannan Huang #, Jianguo Li # contributed equally to this article and should be considered co-first authors.Co-corresponding authors: Xuqi He *, Kai Li * contributed equally to this article and should be considered co-corresponding authors.

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Thermal ablation of hepatocellular carcinoma in patients with abnormal coagulation function

Abstract: With gastroscopy before ablation, platelet concentrate or fresh frozen plasma transfusion during ablation and CEUS-guided ablation to cease needle tract bleeding, thermal ablation is a safe treatment for HCC in patients with abnormal coagulation function.

Cited by 10 publications

References 34 publications

Contrast-enhanced Ultrasound for Evaluation of Active Needle Tract Bleeding during Thermal Ablation of Liver Cancer

Contrast-enhanced Ultrasound for Evaluation of Active Needle Tract Bleeding during Thermal Ablation of Liver Cancer

Value of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery

Value of artificial ascites to assist thermal ablation of liver cancer adjacent to the gastrointestinal tract in patients with previous abdominal surgery

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