Clinical, Morphological Justification and First Experience in the Use of Radiofrequency as Well as Microwave Ablation Treatment Methods of Liver Echinococcosis.

Abstract

The current study considers a new direction of surgical treatment of liver echinococcosis - the use of minimally invasive treatment methods of parasitic cysts. After clinical and morphological substantiation of the very possibility of carrying out such procedures, 9 microwave ablations (MWA) and 3 radiofrequency ablations (RFA) of cysts were performed in patients with liver echinococcosis from 2017 to 2021 in the surgical clinic of Botkin Hospital, Moscow, Russia. A comparative analysis of treatment results of patients with echinococcal liver cysts (12 patients who underwent "percutaneous puncture, aspiration, injection and reaspiration" (PAIR) procedure and 12 patients - MWA and RFA) was carried out. The number of complications according to Clavien-Dindo classification was as follows: 8 after PAIR procedure, 3 after RFA and 3 after MWA. The median hospital length of stay (LOS) after PAIR procedure was 6.46 days versus 4.7 and 4 in the groups of patients who underwent RF and MW ablation, respectively. The frequency of relapses within the first year after PAIR procedure was 25%. The patients who underwent ablation procedures had no relapses of liver echinococcosis during observation. The presented clinical and morphological substantiation and the experience of using various types of ablation techniques on echinococcal cysts, as well as a comparative analysis with a commonly used PAIR treatment method, demonstrated the safety of RFA and MWA for the patient and efficacy in relation to the hydatid process.