Artificial ascites-assisted ultrasound guided percutaneous radiofrequency ablation of liver tumors adjacent to the gastrointestinal tract

Abstract

Objective To study the safety and efficacy of artificial ascites-assisted ultrasound guided percutaneous radiofrequency ablation (RFA) of liver tumors adjacent to the gastrointestinal tract. Methods After ultrasound-guided percutaneous placement of a central venous tube, saline was injected into the abdominal cavity. The presence of fluid between the liver tumor and its adjacent gastrointestinal organs forms a zone of isolation. Radiofrequency ablation (RFA) was then carried out. This is a retrospective study on 32 patients whose lesions were adjacent to the gastrointestinal tract treated from January 2015 to December 2016 with RFA after establishment of artificial ascites. One month after ablation, CT/MR was performed to evaluate whether the lesions were completely ablated. Results All the 39 lesions in the 32 patients were successfully treated with RFA after establishment of artificial ascites. The complete ablation rate was 92.3% (30/32) after one ablation session. One patient developed a high fever after surgery, another patient had nausea and vomiting during surgery, and two more patients complained of right shoulder and back pain. There were no severe complications such as hemorrhage or gastrointestinal perforation. There was no treatment related deaths. Conclusions For liver tumors which were adjacent to the gastrointestinal tract, establishment of artificial ascites significantly improved the visual field under ultrasound, and reduced the chance of collateral gastrointestinal thermal injury. The treatment of ascites-assisted ultrasound guided percutaneous radiofrequency ablation of liver cancer was safe and efficacious. Key words: Hepatocellular carcinoma; Radiofrequency ablation; Artificial ascites; Ultrasonography