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Diaphragmatic Hernia After Lung Percutaneous Radiofrequency Ablation: Incidence and Risk Factors

  • Clinical Investigation
  • Published:
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Abstract

Purpose

To evaluate diaphragmatic hernias (DH) after percutaneous radiofrequency ablation (PRFA) for basal lung nodules and to detect risk factors.

Materials and Methods

Between January 2009 and December 2012, the presence of DH was retrospectively recorded in all of the patients who underwent PRFA with multitine expandable electrodes for ablation of nodules in the lower lobe. All nodules were classified into three groups according to the location of the tines after deployment relative to the diaphragm: In group 1, the tines were at a distance of >1 cm from the diaphragm; in group 2, at least one tine was in contact with the diaphragm without perforation; and in group 3, at least one tine was perforating the diaphragm.

Results

We recorded 4 cases of DH (3 on the left side, 1 on the right side) in 156 patients (2.3 % of procedures). The delay of onset was 7.8 months. DH occurred in groups 2 (n = 1) and 3 (n = 3). Only the 3 cases that occurred on the left side were symptomatic (2 intussusceptions and 1 gastroesophageal reflux) and were surgically repaired. The electrode was positioned in the center of the diaphragm in all cases.

Conclusion

The central position of the electrode and the contact of at least one tine with the diaphragm after deployment seem to be a risk factor to develop DH.

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Abbreviations

CT:

Computed tomography

PRFA:

Percutaneous radiofrequency ablation

DH:

Diaphragmatic hernia

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Acknowledgments

We are indebted to our patients for allowing us to report their clinical courses. The authors thank Jone Iriondo-Alberdi for editorial assistance with the English language.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Interventional Radiology, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l’Argonne, 33000, Bordeaux, France

    Nicolas Alberti, Xavier Buy, Sultan Al Ammari, Roberto-Luigi Cazzato & Jean Palussiere

  2. Department of Radiology, CHU Grenoble, Clinique Universitaire de Radiologie et d’Imagerie Médicale, 229 cours de l’Argonne, 38043, Grenoble Cedex, France

    Gilbert Ferretti & Valérie Monnin-Bares

  3. Department of Oncology, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l’Argonne, 33000, Bordeaux, France

    Marie Desjardin & Dominique Bechade

  4. Department of Surgery, Institut Bergonié, Comprehensive Cancer Centre, 229 cours de l’Argonne, 33000, Bordeaux, France

    Gregoire Desolneux & Audrey Michot

Authors
  1. Nicolas Alberti
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  2. Gilbert Ferretti
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  3. Xavier Buy
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  11. Jean Palussiere
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Correspondence to Nicolas Alberti.

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Alberti, N., Ferretti, G., Buy, X. et al. Diaphragmatic Hernia After Lung Percutaneous Radiofrequency Ablation: Incidence and Risk Factors. Cardiovasc Intervent Radiol 37, 1516–1522 (2014). https://doi.org/10.1007/s00270-014-0854-9

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  • DOI: https://doi.org/10.1007/s00270-014-0854-9

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