Annals of Surgical Oncology

, Volume 21, Issue 6, pp 1834–1840

A Critical Analysis of Postoperative Morbidity and Mortality After Laparoscopic Radiofrequency Ablation of Liver Tumors

  • Onur Birsen
  • Shamil Aliyev
  • Erol Aksoy
  • Halit E. Taskin
  • Muhammet Akyuz
  • Koray Karabulut
  • Allan Siperstein
  • Eren Berber
Hepatobiliary Tumors

DOI: 10.1245/s10434-014-3526-8

Cite this article as:
Birsen, O., Aliyev, S., Aksoy, E. et al. Ann Surg Oncol (2014) 21: 1834. doi:10.1245/s10434-014-3526-8

Abstract

Background

Although the laparoscopic approach provides certain advantages over the percutaneous radiofrequency thermal ablation (RFA), the morbidity needs to be defined. The aim of this study is to analyze the morbidity and underlying risk factors after laparoscopic RFA of liver tumors.

Methods

Between 1996 and 2012, 910 patients underwent 1,207 RFA procedures for malignant liver tumors in a tertiary academic center. The 90-day morbidity and mortality were extracted from a prospective IRB-approved database. Statistical analyses were performed using regression, t, and χ2 tests.

Results

Complications occurred in 50 patients (4 %) and were gastrointestinal in 13 patients (1.1 %), infections in 10 (0.8 %), hemorrhagic in 9 (0.7 %), urinary in 7 (0.6 %), cardiac in 4 (0.3 %), pulmonary in 3 (0.3 %), hematologic in 2 (0.2 %), and neurologic in 2 (0.2 %). The complication rates for an RFA done alone (5 %) versus concomitantly with ancillary procedure (6 %) were similar (p = .6). In all patients who developed postoperative bleeding from the liver, the ablations had been performed on lesions located in the right posterior sector. Of 9 patients with bleeding, 5 (55 %) required a laparotomy. Also, 60 % of liver abscesses occurred in patients with a prior bilioenteric anastomosis (BEA). The 90-day mortality was 0.4 % (n = 5). Hospital stay was 1.2 ± 0.1 days and was prolonged to 4.4 ± 0.3 days in case of complications.

Conclusions

This study describes the morbidity and mortality to be expected after a laparoscopic RFA procedure. Our results show that additional caution should be used to prevent bleeding complications in patients with tumors located in the right posterior sector and infections in patients with a history of BEA.

Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Onur Birsen
    • 1
  • Shamil Aliyev
    • 1
  • Erol Aksoy
    • 1
  • Halit E. Taskin
    • 1
  • Muhammet Akyuz
    • 1
  • Koray Karabulut
    • 1
  • Allan Siperstein
    • 1
  • Eren Berber
    • 1
  1. 1.Department of Endocrine SurgeryCleveland ClinicClevelandUSA