Objective:

To investigate the efficacy and safety of ultrasound-guided percutaneous non-contact combined contact radiofrequency ablation in the treatment of subcapsular small hepatocellular carcinoma.

Methods:

The clinical data of 32 patients with subcapsular hepatocellular carcinoma who received ultrasound-guided non-contact combined contact radiofrequency ablation in Shuguang Hospital

Affiliated to Shanghai University of Chinese Medicine from Jan. 2015 to Jan. 2019 were retrospectively analyzed. Among them

24 patients were male and 8 were female

aged from 36-82 year

with an average age of (58.010.1) year. The maximum diameter of the lesions ranged from 0.80 to 2.95 cm

the average diameter was (1.840.53) cm. The effect of ablation

complication rate and recurrence rate were observed and recorded.

Results

Thirty-two patients with a total of 39 lesions were successfully treated with ultrasound-guided non-contact combined contact radiofrequency ablation. Intraoperatively

artificial pleural ascites were performed in 3 cases

artificial abdominal ascites in 18 cases

artificial abdominal and pleural ascites in 2 cases

and no auxiliary interventions in 9 cases. Postoperative liver abscess accompanied by biloma occurred in 1 case

and fever occurred in 6 cases

including 2 cases whose body temperature exceeded 38 ℃. No serious complication such as intraoperative or postoperative bleeding at the puncture site

injury of diaphragm

gastrointestinal tract

gallbladder injury

abdominal wall and skin scald

gastrointestinal bleeding

intra-abdominal bleeding

peritonitis and liver failure occurred. Intraoperative real-time contrast-enhanced ultrasound was performed immediately

which indicated that the lesion was completely ablated. Re-examination one month afterradiofrequency ablation showed that all 39 lesions were completely inactivated

with a complete blative rate of 100%. The patients were followed up for 12 to 48 months

and the 1-year survival rate was 100%. During the postoperative follow-up

intrahepatic recurrence occurred in 4 cases. No tumor was found at the peri-liver area or the abdominal cavity.

Conclusion:

Ultrasound-guided non-contact combined contact radiofrequency ablation for the treatment of small subcapsular hepatocellular carcinoma is feasible

safe and effective

and is worthy of clinical application.