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Radiofrequency Ablation of Lung Tumors Still Considered a Safe Procedure

February 12, 2008
Written by: , Filed in: Chest Radiology
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The objective of a recent study was to assess the effect of various factors on the complications and side effects associated with CT-guided radiofrequency ablation (RFA) of lung tumors.
This retrospective review has concluded that patients with emphysema need to be counseled about the increased risk of complications occurring after CT-guided radiofrequency ablation of lung tumors.

Methodology
57 patients underwent 112 treatment sessions of CT-guided RFA of unresectable lung tumors. Several risk factors were analyzed, including gender, age, tumor diameter, location, prior surgery, chronic obstructive pulmonary disease, electrode size, patient position, and ablation time.

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Results of the Study
The total rate of side effects was 17%, the total rate of minor complications was 50%, and the total rate of major complications was 8%. Minor complications included pneumothorax not requiring chest tube, subcutaneous emphysema, and hemoptysis.

Major complications included fever, lung abscess, pneumothorax requiring chest tube placement, and air embolism.

Multivariate analysis demonstrated that lesions located <=1 cm of the chest wall were significantly associated with pain. The risk of pneumothorax increased significantly with a history of prior lung surgery and with the presence of emphysema. No other factors significantly influenced complications after RFA. Conclusions
After CT-guided RFA of unresectable lung tumors, the overall complication rate was 58%, with major complications occurring in 8% of cases. RFA still can be considered a safe and minimally invasive procedure. Air embolism is rarely seen after transthoracic lung biopsy and RFA, but it can be potentially fatal if not treated aggressively.

Author: Sohail Contractor, MD

Reference:
Okuma T, Matsuoka T, et al. Frequency and Risk Factors of Various Complications After Computed Tomography-Guided Radiofrequency Ablation of Lung Tumors. Cardiovasc Intervent Radiol; 2008; 31 (January-February): 122-130

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