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ID 54418
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Author
Fujiwara, Hiroyasu Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science ORCID Kaken ID researchmap
Arai, Yasuaki Diagnostic Radiology Division, National Cancer Center Hospital
Ishii, Hiroaki Diagnostic Radiology Division, National Cancer Center Hospital
Kanazawa, Susumu Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science Kaken ID publons
Abstract
We retrospectively evaluated the safety and efficacy of artificial pneumothorax induction to perform computed tomography (CT)-guided radiofrequency ablation (RFA) for sub-diaphragm hepatocellular carcinomas (HCCs). From June 2008 to October 2010 at our institution, 19 HCCs (16 patients) were treated using CT-guided RFA after artificial pneumothorax induction. A 23-G needle was inserted into the liver surface at a site of 2 connected pleurae without lung tissue. After a small amount of air was injected, the pleural space widened, creating a small pneumothorax. Additional air was insufflated via a newly inserted 18-G cannula to raise the lung away from the planned puncture line for RFA. The electrode was then advanced transthoracically. Ablation was performed using a cool-tip electrode with manual impedance control mode. The injected air was then aspirated as much as possible. Artificial pneumothorax was successfully induced in all cases. The average total volume of injected air in each case was 238ml. No artificial pneumothorax-related complication occurred; lung injury occurred in one case during RF electrode insertion. No local progression occurred during follow-up. Recurring HCCs were observed in eight patients. Artificial pneumothorax induction is safe and effective for CT-guided RFA of sub-diaphragm HCCs, which are difficult to locate on US.
Keywords
hepatocellular carcinoma
liver
radiofrequency ablation
CT fluoroscopy
artificial pneumothorax
Amo Type
Original Article
Publication Title
Acta Medica Okayama
Published Date
2016-06
Volume
volume70
Issue
issue3
Publisher
Okayama University Medical School
Start Page
189
End Page
195
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
English
Copyright Holders
CopyrightⒸ 2016 by Okayama University Medical School
File Version
publisher
Refereed
True
PubMed ID
Web of Science KeyUT