Microwave Ablation of Hepatic Tumors Abutting the Diaphragm Is Safe and Effective
| العنوان: | Microwave Ablation of Hepatic Tumors Abutting the Diaphragm Is Safe and Effective |
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| المؤلفون: | Christopher L. Brace, Douglas R. Kitchin, Fred T. Lee, Meghan G. Lubner, J. Louis Hinshaw, Timothy J. Ziemlewicz, Amanda R. Smolock |
| المصدر: | American Journal of Roentgenology. 204:197-203 |
| بيانات النشر: | American Roentgen Ray Society, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, medicine.medical_treatment, Diaphragmatic breathing, Article, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Diaphragmatic hernia, Microwaves, Retrospective Studies, Hernia, Diaphragmatic, Fibrous capsule of Glisson, business.industry, Liver Neoplasms, Microwave ablation, General Medicine, Middle Aged, medicine.disease, Ablation, Diaphragm (structural system), Surgery, Radiography, Treatment Outcome, Tumor progression, Catheter Ablation, Female, Radiology, business, Ablation zone |
| الوصف: | OBJECTIVE. The purpose of this study was to evaluate the incidence of clinically significant diaphragmatic injuries and local tumor progression after microwave ablation of hepatic tumors abutting the diaphragm. MATERIALS AND METHODS. This retrospective study included 55 peripheral hepatic tumors abutting the diaphragm treated by microwave ablation versus a control group of 15 centrally located tumors. Treated tumors were further subdivided according to the use of artificial ascites (fluid vs no fluid) and whether instilled fluid achieved displacement of the liver surface away from the diaphragm (displaced vs nondisplaced). Measurements of tumor size, distance to the diaphragm, ablation zone size, displacement distance, length of the ablation zone along the liver capsule, diaphragm thickness, diaphragmatic hernia, and local tumor progression were made on pre- and postablation CT and MRI. The electronic medical record was reviewed for patient self-reported pain scores and other symptoms. Data were analyzed by use of the Kruskal-Wallis and Fisher exact tests. RESULTS. There were no cases of diaphragmatic hernia in peripheral or central tumors. Postablation diaphragm thickness was higher in peripheral hepatic tumors than in control tumors. Peripheral tumors had an overall higher incidence of postprocedure shoulder pain (18% vs 0%) and local tumor progression (5.5% vs 0%) compared with control tumors, but these differences did not achieve statistical significance (p = 0.2 and p = 1, respectively). CONCLUSION. Our study shows that microwave ablation of peridiaphragmatic hepatic tumors is safe, without incidence of diaphragmatic hernia, and can be performed with a low rate of local tumor progression. |
| تدمد: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.14.12879 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3a51dc1e46d48c22c9bbe4ced4c6507a https://doi.org/10.2214/ajr.14.12879 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3a51dc1e46d48c22c9bbe4ced4c6507a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15463141 0361803X |
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| DOI: | 10.2214/ajr.14.12879 |