Similar complication rates for irreversible electroporation and thermal ablation in patients with hepatocellular tumors
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Über diesen Artikel
Article Category: Research Article
Online veröffentlicht: 03. März 2019
Seitenbereich: 116 - 122
Eingereicht: 02. Nov. 2018
Akzeptiert: 22. Jan. 2019
DOI: https://doi.org/10.2478/raon-2019-0011
© 2019 Niklas Verloh, Isabel Jensch, Lukas Lürken, Michael Haimerl, Marco Dollinger, Philipp Renner, Philipp Wiggermann, Jens Martin Werner, Florian Zeman, Christian Stroszczynski, Lukas Philipp Beyer, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Figure 1
Figure 2
Clavien & Dindo classification system with the corresponding number of events in the thermal and non-thermal irreversible electroporation (IRE) groups
| Clavien-Dindo Classification | SIR Classification 2017 | RFA/MWA (n = 117) | IRE (n = 47) | |
|---|---|---|---|---|
| Grade | Description | |||
| 0 | No complication | No complication | 82 (70.1%) | 30 (63.8%) |
| Any deviation from the normal postinterventional course without the need for pharmacological treatment or surgical, endoscopic and radiological interventions | ||||
| I | (Allowed therapeutic regimens are: drugs as antiemetics, antipyretics, analgesics, | Mild | 11 (9.4%) | 9 (19.1%) |
| diuretics, and electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside) | ||||
| II | Requiring pharmacological treatment with drugs other than such allowed for grade I complications. Blood transfusions and total parenteral nutrition are also included. | Moderate | 20 (17.1%) | 7 (14.9%) |
| III | requiring surgical, endoscopic or radiological intervention | |||
| IIIa | intervention not under general anesthesia | Moderate | 1 (0.9%) | 0 |
| IIIb | intervention under general anesthesia | Severe | 1 (0.9%) | 1 (2.1%) |
| IV | Life-threatening complication (including CNS complications) requiring IC/ICU-management | |||
| IVa | single organ dysfunction (including dialysis) | Severe/Life- threatening | 0 | 0 |
| IVb | multi organ dysfunction | Life-threatening | 1 (0.9%) | 0 |
| V | Death of a patient | Patient death | 1 (0.9%) | 0 |
Patient and tumor characteristics of the RFA/MWA and IRE group
| RFA/MWA (n = 117) | IRE (n = 47) | p-value | |
|---|---|---|---|
| Male, n (%) | 98 (83.8) | 46 (97.9) | |
| Age | |||
| median (IQR) | 66 (14) | 71 (15) | 0.239 |
| range | 45 - 82 | 45 - 83 | |
| Child-Pugh-Score, n (%) | 0.892 | ||
| A | 76 (65.0) | 30 (63.8) | |
| B | 41 (35.0) | 17 (36.2) | |
| BCLC, n (%) | 0.412 | ||
| A | 68 (58.1) | 24 (51.1) | |
| B | 49 (41.9) | 23 (48.9) | |
| Tumor size, mm (mean +- SD) | 22 +- 9 | 20 +- 8 | 0.186 |
| Liver periphery, n (%) | 85 (72.6) | 25 (53.2) | |
| Close to a major vessel, n (%) | 19 (16.2) | 21 (44.7) |
Intervention durations, hospital and intensive care unit (ICU) stay, occurrence of post-ablation syndrome for thermal ablation and non-thermal irreversible electroporation (IRE)
| All (164) | RFA/(n = MWA 117) | IRE (n = 47) | p-vale | |
|---|---|---|---|---|
| Intervention (IQR) duration, minutes | 113 (96) | 103 (103) | 142 (88) | |
| Hospital Stay, days | ||||
| days, median (IQR) | 5 (4) | 5 (4) | 5 (4) | 0.752 |
| days, range | 2-50 | 2-50 | 2-20 | |
| ICU Stay, n (%) | 17 (10) | 14 (12) | 3 (6) | 0.302 |
| days, median (IQR) | 4 (5) | 4 (4) | 6 (-) | 0.222 |
| days, range | 1-9 | 1-9 | 3-9 | |
| Post-ablation Syndrome, n (%) | 28 (17) | 21 (18) | 7 (15) | 0.607 |