Analysis of influencing factors for complications during percutaneous radiofrequency ablation of pulmonary tumor_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LIU Lei , ZHANG Yi , ZHI Xiuyi , LIU Baodong

Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P. R. China;

Corresponding author：

LIU Lei, Email: mtv12@sina.com

Keywords：

Pulmonary tumor; radiofrequency ablation; intraoperative complications; pneumothorax; intrapulmonary hemorrhage

DOI：

10.7507/1007-4848.202111047

Video：

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Objective To explore and analyze the related influencing factors for common intraoperative complications during CT-guided percutaneous radiofrequency ablation of pulmonary tumor. Methods We retrospectively analyzed the clinical data of the patients who underwent CT-guided percutaneous radiofrequency ablation of pulmonary tumor in our hospital from December 2018 to December 2019, and analyzed the influencing factors for complications. Results A total of 106 patients were enrolled. There were 58 (54.7%) males and 48 (45.3%) females aged 46-81 (68.05±8.05) years. All patients successfully completed the operation. The operation time was 47.67±16.47 min, and the hospital stay time was 2.45±1.35 d. The main intraoperative complications were pneumothorax (16.0%, 17/106) and intrapulmonary hemorrhage (22.6%, 24/106). Univariate analysis showed that the number of pleural punctures had an impact on the occurrence of pneumothorax (P=0.00). The length of the puncture path (P=0.00), ablation range (P=0.03) and ablation time (P=0.00) had an impact on the occurrence of intrapulmonary hemorrhage. Multivariate logistic regression analysis showed that the size of the lesion (OR=17.85, 95%CI 3.41-93.28, P=0.00) and the number of pleural punctures (OR=0.02, 95%CI 0.00-0.11, P=0.00) were independent influencing factors for the occurrence of pneumothorax. The length of the puncture path (OR=15.76, 95%CI 5.34-46.57, P=0.00) was the independent influencing factor for the occurrence of intrapulmonary hemorrhage. Conclusion Percutaneous radiofrequency ablation of pulmonary tumor is safe and with a high success rate, but intraoperative complications are affected by many factors, so the surgeons should be proficient in operating skills to avoid complications.

Citation： LIU Lei, ZHANG Yi, ZHI Xiuyi, LIU Baodong. Analysis of influencing factors for complications during percutaneous radiofrequency ablation of pulmonary tumor. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(8): 1164-1168. doi: 10.7507/1007-4848.202111047 Copy

1.	Picchi SG, Lassandro G, Bianco A, et al. RFA of primary and metastatic lung tumors: Long-term results. Med Oncol, 2020, 37(5): 35.
2.	Li M, Qin Y, Mei A, et al. Effectiveness of radiofrequency ablation therapy for patients with unresected stageⅠA non-small cell lung cancer. J Cancer Res Ther, 2020, 16(5): 1007-1013.
3.	Yuan Z, Wang Y, Zhang J, et al. A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases. J Am Coll Radiol, 2019, 16(3): 302-314.
4.	刘宝东, 叶欣, 范卫君, 等. 影像引导射频消融治疗肺部肿瘤专家共识(2018年版). 中国肺癌杂志, 2018, 21(2): 76-88.
5.	Nour-Eldin NE, Naguib NN, Mack M, et al. Pulmonary hemorrhage complicating radiofrequency ablation, from mild hemoptysis to life-threatening pattern. Eur Radiol, 2011, 21(1): 197-204.
6.	Quirk MT, Lee S, Murali N, et al. Alternatives to surgery for early-stage non-small cell lung cancer: Thermal ablation. Clin Chest Med, 2020, 41(2): 197-210.
7.	Gao Y, Chen J, Zhang J, et al. Radiofrequency ablation of primary non-small cell lung cancer: A retrospective study on 108 patients. J Buon. 2019, 24(4): 1610-1618.
8.	Prud'homme C, Deschamps F, Moulin B, et al. Image-guided lung metastasis ablation: A literature review. Int J Hyperthermia, 2019, 36(2): 37-45.
9.	Kim MS, Hong HP, Ham SY, et al. Complications after 100 sessions of cone-beam computed tomography-guided lung radiofrequency ablation: A single-center, retrospective experience. Int J Hyperthermia, 2020, 37(1): 763-771.
10.	Zhou X, Li H, Qiao Q, et al. CT-guided percutaneous minimally invasive radiofrequency ablation for the relief of cancer related pain from metastatic non-small cell lung cancer patients: A retrospective study. Ann Palliat Med, 2021, 10(2): 1494-1502.
11.	Hiraki T, Tajiri N, Mimura H, et al. Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: Incidence and risk factors. Radiology, 2006, 241(1): 275-283.
12.	Kennedy SA, Milovanovic L, Dao D, et al. Risk factors for pneumothorax complicating radiofrequency ablation for lung malignancy: A systematic review and meta-analysis. J Vasc Interv Radiol, 2014, 25(11): 1671-1681.
13.	Streitparth T, Schumacher D, Damm R, et al. Percutaneous radiofrequency ablation in the treatment of pulmonary malignancies: Efficacy, safety and predictive factors. Oncotarget, 2018, 9(14): 11722-11733.
14.	Jiang B, Mcclure MA, Chen T, et al. Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis. Ann Thorac Med, 2018, 13(4): 243-250.
15.	Lencioni R, Crocetti L, Cioni R, et al. Radiofrequency ablation of lung malignancies: Where do we stand? Cardiovasc Intervent Radiol. 2004, 27(6): 581-590.
16.	Ogawa E, Fukuse T, Toda Y, et al. Effects and risks of radiofrequency ablation on the pulmonary tissue and vascular system: A preliminary histological study. Surg Today, 2008, 38(5): 425-431.
17.	Hiraki T, Gobara H, Shibamoto K, et al. Technique for creation of artificial pneumothorax for pain relief during radiofrequency ablation of peripheral lung tumors: Report of seven cases. J Vasc Interv Radiol. 2011, 22(4): 503-506.
18.	Lee EW, Suh RD, Zeidler MR, et al. Radiofrequency ablation of subpleural lung malignancy: Reduced pain using an artificially created pneumothorax. Cardiovasc Intervent Radiol, 2009, 32(4): 833-836.

1. Picchi SG, Lassandro G, Bianco A, et al. RFA of primary and metastatic lung tumors: Long-term results. Med Oncol, 2020, 37(5): 35.
2. Li M, Qin Y, Mei A, et al. Effectiveness of radiofrequency ablation therapy for patients with unresected stageⅠA non-small cell lung cancer. J Cancer Res Ther, 2020, 16(5): 1007-1013.
3. Yuan Z, Wang Y, Zhang J, et al. A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases. J Am Coll Radiol, 2019, 16(3): 302-314.
4. 刘宝东, 叶欣, 范卫君, 等. 影像引导射频消融治疗肺部肿瘤专家共识(2018年版). 中国肺癌杂志, 2018, 21(2): 76-88.
5. Nour-Eldin NE, Naguib NN, Mack M, et al. Pulmonary hemorrhage complicating radiofrequency ablation, from mild hemoptysis to life-threatening pattern. Eur Radiol, 2011, 21(1): 197-204.
6. Quirk MT, Lee S, Murali N, et al. Alternatives to surgery for early-stage non-small cell lung cancer: Thermal ablation. Clin Chest Med, 2020, 41(2): 197-210.
7. Gao Y, Chen J, Zhang J, et al. Radiofrequency ablation of primary non-small cell lung cancer: A retrospective study on 108 patients. J Buon. 2019, 24(4): 1610-1618.
8. Prud'homme C, Deschamps F, Moulin B, et al. Image-guided lung metastasis ablation: A literature review. Int J Hyperthermia, 2019, 36(2): 37-45.
9. Kim MS, Hong HP, Ham SY, et al. Complications after 100 sessions of cone-beam computed tomography-guided lung radiofrequency ablation: A single-center, retrospective experience. Int J Hyperthermia, 2020, 37(1): 763-771.
10. Zhou X, Li H, Qiao Q, et al. CT-guided percutaneous minimally invasive radiofrequency ablation for the relief of cancer related pain from metastatic non-small cell lung cancer patients: A retrospective study. Ann Palliat Med, 2021, 10(2): 1494-1502.
11. Hiraki T, Tajiri N, Mimura H, et al. Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors: Incidence and risk factors. Radiology, 2006, 241(1): 275-283.
12. Kennedy SA, Milovanovic L, Dao D, et al. Risk factors for pneumothorax complicating radiofrequency ablation for lung malignancy: A systematic review and meta-analysis. J Vasc Interv Radiol, 2014, 25(11): 1671-1681.
13. Streitparth T, Schumacher D, Damm R, et al. Percutaneous radiofrequency ablation in the treatment of pulmonary malignancies: Efficacy, safety and predictive factors. Oncotarget, 2018, 9(14): 11722-11733.
14. Jiang B, Mcclure MA, Chen T, et al. Efficacy and safety of thermal ablation of lung malignancies: A Network meta-analysis. Ann Thorac Med, 2018, 13(4): 243-250.
15. Lencioni R, Crocetti L, Cioni R, et al. Radiofrequency ablation of lung malignancies: Where do we stand? Cardiovasc Intervent Radiol. 2004, 27(6): 581-590.
16. Ogawa E, Fukuse T, Toda Y, et al. Effects and risks of radiofrequency ablation on the pulmonary tissue and vascular system: A preliminary histological study. Surg Today, 2008, 38(5): 425-431.
17. Hiraki T, Gobara H, Shibamoto K, et al. Technique for creation of artificial pneumothorax for pain relief during radiofrequency ablation of peripheral lung tumors: Report of seven cases. J Vasc Interv Radiol. 2011, 22(4): 503-506.
18. Lee EW, Suh RD, Zeidler MR, et al. Radiofrequency ablation of subpleural lung malignancy: Reduced pain using an artificially created pneumothorax. Cardiovasc Intervent Radiol, 2009, 32(4): 833-836.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis of influencing factors for complications during percutaneous radiofrequency ablation of pulmonary tumor

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