Skip to main content
SpringerLink
Log in

Artificial Ascites in Assisting Percutaneous Microwave Ablation for Hepatic Tumors Adjacent to the Gastrointestinal Tract

  • Chapter
  • First Online:
Microwave Ablation Treatment of Solid Tumors

  • 1182 Accesses

Abstract

When a hepatic tumor is adjacent to the gastrointestinal tract (GT), the thermal ablation therapy could probably damage the GT to induce serious complications. Gastrointestinal perforation is the most important extrahepatic complication due to thermal damage, especially in patients with a history of celiac operation or transcatheter hepatic arterial chemoembolization. Therefore, it is challengeable to use percutaneous thermal ablation to treat hepatic tumors adjacent to the GT safely and effectively. Several experimental and clinical researches verified that artificial ascites is a safe and effective strategy in using radiofrequency ablation to treat hepatic tumors adjacent to the GT. Few clinical researches concerning microwave ablation (MWA) with artificial ascites for the treatment of such tumors have been reported. The result of our clinical study verifies that ultrasound-guided percutaneous microwave ablation assisted with artificial ascites is a safe and effective method for the treatment of primary and metastatic hepatic tumors adjacent to the GT and can achieve good local control of such tumors. In this chapter, we will introduce artificial ascites technique in assisting percutaneous microwave ablation for hepatic tumors adjacent to the GT: overview, technique, efficacy, and safety.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

GT:

Gastrointestinal tract

RFA:

Radiofrequency ablation

MWA:

Microwave ablation

References

  1. Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN. Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology. 2003;226:441–51.

    Article  PubMed  Google Scholar 

  2. Song I, Rhim H, Lim HK, Kim YS, Choi D. Percutaneous radiofrequency ablation of hepatocellular carcinoma abutting the diaphragm and gastrointestinal tracts with the use of artificial ascites: safety and technical efficacy in 143 patients. Eur Radiol. 2009;19:2630–40.

    Article  PubMed  Google Scholar 

  3. Liang P, Wang Y, Yu X, Dong B. Malignant liver tumors: treatment with percutaneous microwave ablation–complications among cohort of 1136 patients. Radiology. 2009;251:933–40.

    Article  PubMed  Google Scholar 

  4. Tateishi R, Shiina S, Teratani T, Obi S, Sato S, Koike Y, Fujishima T, Yoshida H, Kawabe T, Omata M. Percutaneous radiofrequency ablation for hepatocellular carcinoma. An analysis of 1000 cases. Cancer. 2005;103:1201–9.

    Article  PubMed  Google Scholar 

  5. Koda M, Murawaki Y, Hirooka Y, Kitamoto M, Ono M, Sakaeda H, Joko K, Sato S, Tamaki K, Yamasaki T, Shibata H, Shimoe T, Matsuda T, Toshikuni N, Fujioka S, Ohmoto K, Nakamura S, Kariyama K, Aikata H, Kobayashi Y, Tsutsui A. Complications of radiofrequency ablation for hepatocellular carcinoma in a multicenter study: an analysis of 16 346 treated nodules in 13 283 patients. Hepatol Res. 2012;42:1058–64.

    Article  PubMed  Google Scholar 

  6. Livraghi T, Meloni F, Solbiati L, Zanus G. Complications of microwave ablation for liver tumors: results of a multicenter study. Cardiovasc Intervent Radiol. 2012;35:868–74.

    Article  PubMed  Google Scholar 

  7. Hirooka M, Kisaka Y, Uehara T, Ishida K, Kumagi T, Watanabe Y, Abe M, Matsuura B, Hiasa Y, Onji M. Efficacy of laparoscopic radiofrequency ablation for hepatocellular carcinoma compared to percutaneous radiofrequency ablation with artificial ascites. Dig Endosc. 2009;21:82–6.

    Article  PubMed  Google Scholar 

  8. Yamakado K, Nakatsuka A, Akeboshi M, Takeda K. Percutaneous radiofrequency ablation of liver neoplasms adjacent to the gastrointestinal tract after balloon catheter interposition. J Vasc Interv Radiol. 2003;14:1183–6.

    Article  PubMed  Google Scholar 

  9. Toyoda H, Kumada T, Tada T, Kaneoka Y, Maeda A. Placement of a sodium hyaluronate solution onto the liver surface as a supportive procedure for radiofrequency ablation of hepatocellular carcinomas located on the liver surface: a preliminary report. J Vasc Interv Radiol. 2012;23:1639–45 e1.

    Article  PubMed  Google Scholar 

  10. Lee EJ, Rhim H, Lim HK, Choi D, Lee WJ, Min KS. Effect of artificial ascites on thermal injury to the diaphragm and stomach in radiofrequency ablation of the liver: experimental study with a porcine model. AJR Am J Roentgenol. 2008;190:1659–64.

    Article  PubMed  Google Scholar 

  11. Uehara T, Hirooka M, Ishida K, Hiraoka A, Kumagi T, Kisaka Y, Hiasa Y, Onji M. Percutaneous ultrasound-guided radiofrequency ablation of hepatocellular carcinoma with artificially induced pleural effusion and ascites. J Gastroenterol. 2007;42:306–11.

    Article  PubMed  Google Scholar 

  12. Nishimura M, Nouso K, Kariyama K, Wakuta A, Kishida M, Wada N, Higashi T, Yamamoto K. Safety and efficacy of radiofrequency ablation with artificial ascites for hepatocellular carcinoma. Acta Med Okayama. 2012;66:279–84.

    PubMed  Google Scholar 

  13. Laeseke PF, Sampson LA, Brace CL, Winter 3rd TC, Fine JP, Lee Jr FT. Unintended thermal injuries from radiofrequency ablation: protection with 5% dextrose in water. AJR Am J Roentgenol. 2006;186:S249–54.

    Article  PubMed  Google Scholar 

  14. Kondo Y, Yoshida H, Shiina S, Tateishi R, Teratani T, Omata M. Artificial ascites technique for percutaneous radiofrequency ablation of liver cancer adjacent to the gastrointestinal tract. Br J Surg. 2006;93:1277–82.

    Article  CAS  PubMed  Google Scholar 

  15. Park SY, Tak WY, Jeon SW, Cho CM, Kweon YO, Kim SK, Choi YH. The efficacy of intraperitoneal saline infusion for percutaneous radiofrequency ablation for hepatocellular carcinoma. Eur J Radiol. 2010;74:536–40.

    Article  PubMed  Google Scholar 

  16. Kim YS, Rhim H, Choi D, Lim HK. Does artificial ascites induce the heat-sink phenomenon during percutaneous radiofrequency ablation of the hepatic subcapsular area?: an in vivo experimental study using a rabbit model. Korean J Radiol. 2009;10:43–50.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Wright AS, Sampson LA, Warner TF, Mahvi DM, Lee Jr FT. Radiofrequency versus microwave ablation in a hepatic porcine model. Radiology. 2005;236:132–9.

    Article  PubMed  Google Scholar 

  18. Andreano A, Huang Y, Meloni MF, Lee Jr FT, Brace C. Microwaves create larger ablations than radiofrequency when controlled for power in ex vivo tissue. Med Phys. 2010;37:2967–73.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Li X, Zhang L, Fan W, Zhao M, Wang L, Tang T, Jiang H, Zhang J, Liu Y. Comparison of microwave ablation and multipolar radiofrequency ablation, both using a pair of internally cooled interstitial applicators: results in ex vivo porcine livers. Int J Hyperthermia. 2011;27:240–8.

    Article  PubMed  Google Scholar 

  20. Qian GJ, Wang N, Shen Q, Sheng YH, Zhao JQ, Kuang M, Liu GJ, Wu MC. Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies. Eur Radiol. 2012;22:1983–90.

    Article  PubMed  Google Scholar 

  21. Liang P, Yu J, Yu XL, Wang XH, Wei Q, Yu SY, Li HX, Sun HT, Zhang ZX, Liu HC, Cheng ZG, Han ZY. Percutaneous cooled-tip microwave ablation under ultrasound guidance for primary liver cancer: a multicentre analysis of 1363 treatment-naive lesions in 1007 patients in china. Gut. 2012;61:1100–1.

    Article  PubMed  Google Scholar 

  22. Yin XY, Xie XY, Lu MD, Xu HX, Xu ZF, Kuang M, Liu GJ, Liang JY, Lau WY. Percutaneous thermal ablation of medium and large hepatocellular carcinoma: long-term outcome and prognostic factors. Cancer. 2009;115:1914–23.

    Article  CAS  PubMed  Google Scholar 

  23. Shiomi H, Naka S, Sato K, Demura K, Murakami K, Shimizu T, Morikawa S, Kurumi Y, Tani T. Thoracoscopy-assisted magnetic resonance guided microwave coagulation therapy for hepatic tumors. Am J Surg. 2008;195:854–60.

    Article  PubMed  Google Scholar 

  24. Nakazawa T, Kokubu S, Shibuya A, Ono K, Watanabe M, Hidaka H, Tsuchihashi T, Saigenji K. Radiofrequency ablation of hepatocellular carcinoma: correlation between local tumor progression after ablation and ablative margin. AJR Am J Roentgenol. 2007;188:480–8.

    Article  PubMed  Google Scholar 

  25. Nishikawa H, Inuzuka T, Takeda H, Nakajima J, Sakamoto A, Henmi S, Matsuda F, Eso Y, Ishikawa T, Saito S, Kita R, Kimura T, Osaki Y. Percutaneous radiofrequency ablation therapy for hepatocellular carcinoma: a proposed new grading system for the ablative margin and prediction of local tumor progression and its validation. J Gastroenterol. 2011;46:1418–26.

    Article  PubMed  Google Scholar 

  26. Liu LN, Xu HX, Lu MD, Xie XY. Percutaneous ultrasound-guided thermal ablation for liver tumor with artificial pleural effusion or ascites. Chin J Cancer. 2010;29:830–5.

    Article  PubMed  Google Scholar 

  27. Zhou P, Liang P, Yu X, Wang Y, Dong B. Percutaneous microwave ablation of liver cancer adjacent to the gastrointestinal tract. J Gastrointest Surg. 2009;13:318–24.

    Article  PubMed  Google Scholar 

  28. Mohnike K, Wieners G, Pech M, Seidensticker M, Ruhl R, Lopez-Haenninen E, Ricke J. Image-guided interstitial high-dose-rate brachytherapy in hepatocellular carcinoma. Dig Dis. 2009;27:170–4.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

    Min Zhang MD & Ping Liang MD

Authors
  1. Min Zhang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ping Liang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ping Liang MD .

Editor information

Editors and Affiliations

  1. The Dept. of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China

    Ping Liang

  2. The Dept. of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China

    Xiao-ling Yu

  3. The Dept. of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China

    Jie Yu

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Zhang, M., Liang, P. (2015). Artificial Ascites in Assisting Percutaneous Microwave Ablation for Hepatic Tumors Adjacent to the Gastrointestinal Tract. In: Liang, P., Yu, Xl., Yu, J. (eds) Microwave Ablation Treatment of Solid Tumors. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-9315-5_11

Download citation

  • DOI: https://doi.org/10.1007/978-94-017-9315-5_11

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-017-9314-8

  • Online ISBN: 978-94-017-9315-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation