This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Percutaneous radiofrequency ablation of liver cancer in the hepatic dome using the intrapleural fluid infusion technique. BJS 2008; 95: 996-1004.
Published: 25th June 2008
Authors: Y. Kondo, H. Yoshida, R. Tateishi, S. Shiina, T. Kawabe, M. Omata et al.
Background
Intrapleural fluid infusion improves ultrasonographic visualization of tumours in the hepatic dome. The aim of this study was to assess the safety and long‐term efficacy of ultrasonographically guided percutaneous radiofrequency ablation for tumours in the hepatic dome with intrapleural infusion.
Method
Of 2575 patients with hepatocellular carcinoma or hepatic metastases treated with radiofrequency ablation, intrapleural fluid infusion was performed in 587 patients for tumours in the hepatic dome. After the tip of a 14‐G metallic needle was positioned in the pleural cavity under ultrasonographic guidance, 500–1000 ml of 5 per cent glucose solution was infused in 5–15 min. Radiofrequency ablation was performed using an internally cooled electrode. Long‐term results were evaluated in 347 patients with a single hepatocellular carcinoma who were naive to any treatment.
Results
Intrapleural fluid infusion was successfully performed in all 587 patients. The major complication rate on a per tumour basis was similar for patients treated with and without intrapleural infusion (1·6 versus 1·6 per cent; P = 0·924). The overall and recurrence‐free survival were both similar for naive patients with a single hepatocellular carcinoma treated with and without intrapleural infusion (P = 0·429 and P = 0·109 respectively). Intrapleural infusion was not associated with lower overall survival in multivariable analysis.
Conclusion
With intrapleural fluid infusion, radiofrequency ablation for tumours in the hepatic dome was safe and effective, resulting in satisfactory overall and recurrence‐free survival. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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