Severe complications after ultrasound-guided percutaneous microwave coagulation therapy for primary hepatic carcinoma

Objective To investigate the severe complications after ultrasound- guided percutaneous microwave coagulation therapy( PMCT) for primary hepatic carcinoma( PHC) and measures for prevention and treatment. Methods A total of 652 patients with PHC who were admitted to department of hepatobiliary surgery in Air Force General Hospital,PLA from January 2012 to December 2014 were selected,and ultrasound- guided PMCT was performed for all the patients. The occurrence of post- PMCT complications was observed and compared between the years 2012,2013,and 2014. Measures for prevention and treatment were summarized. The chi- square test was applied for comparison of categorical data between groups. Results A total of 18 patients experienced severe PMCT- related complications,with an incidence rate of 2. 76%. These complications included intra- abdominal hemorrhage( n = 10),liver abscess( n = 2),intestinal fistula( n = 1),diaphragmatic rupture( n = 2),acute renal failure( n = 1),tumor implantation metastasis( n = 1),and cardiovascular and cerebrovascular diseases( n = 1). One patient died of the complications above,and the complication- related mortality was 5. 56%( 1 /18). The incidence of PMCT- related complications showed a significant difference between 2012,2013,and 2014( χ2= 11. 78,P = 0. 003). Conclusion Ultrasound- guided PMCT is generally safe,but the patients with liver tumors in special sites,severe liver cirrhosis,and other systemic diseases still have a high risk. The indications for PMCT should be followed strictly,and enhancement in preoperative prophylactic treatment,standard intraoperative procedure,and careful postoperative observation can significantly reduce the adverse outcome caused by PMCT- related complications.