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学科主题临床医学
Intraperitoneal hemorrhage during and after percutaneous radiofrequency ablation of hepatic tumors: reasons and management
Chen, MH1; Dai, Y1; Yan, K1; Yang, W1; Gao, W1; Wu, W1; Liao, SR1; Hao, CY1
关键词Liver Neoplasm Radiofrequency Ablation Complication Intraperitoneal Hemorrhage Ultrasound
刊名CHINESE MEDICAL JOURNAL
2005-10-01
118期:20页:1682-1687
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]LIVER-BIOPSY ; THERMAL ABLATION ; TISSUE ABLATION ; COMPLICATIONS ; METASTASES ; SAFETY
英文摘要

Background Introperitoneal hemorrhage is one of the most common complications of radiofrequency (RF) ablation of hepatic tumors. This study was designed to investigate the reason and management of intraperitoneal hemorrhage occurred during or after percutaneous RF ablation of hepatic tumors.

Methods Three hundred and fifty-six patients with hepatic tumors have been treated at 592 procedures of ultrasound guided RF ablation. Intraperitoneal hemorrhage occurred in 5 patients (0.8%). The reasons and management of intraperitoneal hemorrhage in these 5 cases were retrospectively analyzed.

Results Two patients with liver metastasis and one hepatocellular carcinoma (HCC) patient suffered from hemorrhage during the RF treatment. Two patients with recurrent HCC after surgery developed hemorrhage 20 minutes or 4 hours after RF treatment. One case of hemorrhage was due to the inappropriate electrode positioning induced liver laceration while treating a 1 cm liver metastasis near the liver capsule. One was due to the injury of a small vessel by the RF needle in another liver metastasis patient. Three cases were due to tumor rupture with two cases induced by cough or position change after treating large protruding HCC lesions. Four (80%) of the 5 cases of hemorrhage were rapidly identified by ultrasound. The causes and sites of bleeding during the RF treatment in three cases were confirmed through ultrasound, which were successfully treated using RF coagulation to achieve hemostasis of The bleeding site. Two patients with post-ablation hemorrhage recovered in one hour and 24 hours, respectively after given blood transfusion and other conservative measures. No surgical intervention was required. Two patients died of wide spread metastasis 23 - 36 months afterwards and the other three patients have lived for 18 - 25 months to date.

Conclusions It is important to perform close monitoring during and after RF ablation in order to identify intraperitoneal hemorrhage in time. RF ablation of the bleeding sites was a simple and effective management when the bleeding site could be confirmed by ultrasound. The hemorrhage due to the rupture of large and protruding liver tumors could be serious and should be considered as contraindication for RF treatment.

语种英语
WOS记录号WOS:000232871400002
引用统计
被引频次:7[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/50776
专题北京大学临床肿瘤学院_超声科
北京大学第三临床医学院_心血管内科
北京大学临床肿瘤学院_肝胆胰外二科
作者单位1.Peking Univ, Dept Ultrasound, Sch Oncol, Beijing 100036, Peoples R China
2.Peking Univ, Dept Surg, Sch Oncol, Beijing 100036, Peoples R China
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GB/T 7714
Chen, MH,Dai, Y,Yan, K,et al. Intraperitoneal hemorrhage during and after percutaneous radiofrequency ablation of hepatic tumors: reasons and management[J]. CHINESE MEDICAL JOURNAL,2005,118(20):1682-1687.
APA Chen, MH.,Dai, Y.,Yan, K.,Yang, W.,Gao, W.,...&Hao, CY.(2005).Intraperitoneal hemorrhage during and after percutaneous radiofrequency ablation of hepatic tumors: reasons and management.CHINESE MEDICAL JOURNAL,118(20),1682-1687.
MLA Chen, MH,et al."Intraperitoneal hemorrhage during and after percutaneous radiofrequency ablation of hepatic tumors: reasons and management".CHINESE MEDICAL JOURNAL 118.20(2005):1682-1687.
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