Zhaonan Li1, Chaoyan Wang1, Jing Li1, Zaoqu Liu1, Dechao Jiao2, Xinwei Han3. 1. Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China. 2. Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China. jiaodechao007@126.com. 3. Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China. 13592583911@163.com.
Abstract
BACKGROUND: Percutaneous magnetic resonance-guided (MR-guided) MWA procedures have traditionally been performed under local anesthesia (LA) and sedation. However, pain control is often difficult to manage, especially in some cases when the tumor is large or in a specific location, such as near the abdominal wall or close to the hepatic dome. This study retrospectively compared the results of general anesthesia (GA) and local anesthesia (LA) for MR-guided microwave ablation (MWA) in patients with hepatocellular carcinoma (HCC ≤ 5.0 cm) to investigate whether different anesthesia methods lead to different clinical outcomes. METHODS: The results of the analysis include procedure-related complications, imaging response, and the time to complete two sets of procedures. According to the type of anesthesia, the Kaplan-Meier method was used to compare the local tumor progression (LTP) of the two groups who underwent MR-guided MWA. RESULTS: All patients achieved technical success. The mean ablation duration of each patient in the GA group and LA group was remarkably different (P = 0.012). Both groups had no difference in complications or LTP (both P > 0.05). Notably, the tumor location (challenging locations) and the number of lesions (2-3 lesions) could be the main factors affecting LTP (p = 0.000, p = 0.015). Univariate Cox proportional hazard regression indicated that using different anesthesia methods (GA and LA) was not associated with longer LTP (P = 0.237), while tumor location (challenging locations) and the number of lesions (2-3 lesions) were both related to shorter LTP (P = 0.000, P = 0.020, respectively). Additionally, multivariate Cox regression further revealed that the tumor location (regular locations) and the number of lesions (single) could independently predict better LTP (P = 0.000, P = 0.005, respectively). CONCLUSIONS: No correlation was observed between GA and LA for LTP after MR-guided MWA. However, tumors in challenging locations and the number of lesions (2-3 lesions) appear to be the main factors affecting LTP.
BACKGROUND: Percutaneous magnetic resonance-guided (MR-guided) MWA procedures have traditionally been performed under local anesthesia (LA) and sedation. However, pain control is often difficult to manage, especially in some cases when the tumor is large or in a specific location, such as near the abdominal wall or close to the hepatic dome. This study retrospectively compared the results of general anesthesia (GA) and local anesthesia (LA) for MR-guided microwave ablation (MWA) in patients with hepatocellular carcinoma (HCC ≤ 5.0 cm) to investigate whether different anesthesia methods lead to different clinical outcomes. METHODS: The results of the analysis include procedure-related complications, imaging response, and the time to complete two sets of procedures. According to the type of anesthesia, the Kaplan-Meier method was used to compare the local tumor progression (LTP) of the two groups who underwent MR-guided MWA. RESULTS: All patients achieved technical success. The mean ablation duration of each patient in the GA group and LA group was remarkably different (P = 0.012). Both groups had no difference in complications or LTP (both P > 0.05). Notably, the tumor location (challenging locations) and the number of lesions (2-3 lesions) could be the main factors affecting LTP (p = 0.000, p = 0.015). Univariate Cox proportional hazard regression indicated that using different anesthesia methods (GA and LA) was not associated with longer LTP (P = 0.237), while tumor location (challenging locations) and the number of lesions (2-3 lesions) were both related to shorter LTP (P = 0.000, P = 0.020, respectively). Additionally, multivariate Cox regression further revealed that the tumor location (regular locations) and the number of lesions (single) could independently predict better LTP (P = 0.000, P = 0.005, respectively). CONCLUSIONS: No correlation was observed between GA and LA for LTP after MR-guided MWA. However, tumors in challenging locations and the number of lesions (2-3 lesions) appear to be the main factors affecting LTP.
Entities:
Keywords:
Hepatocellular carcinoma; Interventional radiology; Magnetic resonance imaging; Microwave ablation
Authors: Omid Khalilzadeh; Mark O Baerlocher; Paul B Shyn; Bairbre L Connolly; A Michael Devane; Christopher S Morris; Alan M Cohen; Mehran Midia; Raymond H Thornton; Kathleen Gross; Drew M Caplin; Gunjan Aeron; Sanjay Misra; Nilesh H Patel; T Gregory Walker; Gloria Martinez-Salazar; James E Silberzweig; Boris Nikolic Journal: J Vasc Interv Radiol Date: 2017-07-27 Impact factor: 3.464
Authors: Laura G Merckel; Lambertus W Bartels; Max O Köhler; H J G Desirée van den Bongard; Roel Deckers; Willem P Th M Mali; Christoph A Binkert; Chrit T Moonen; Kenneth G A Gilhuijs; Maurice A A J van den Bosch Journal: Cardiovasc Intervent Radiol Date: 2012-12-12 Impact factor: 2.740
Authors: Aristomenis K Exadaktylos; Donal J Buggy; Denis C Moriarty; Edward Mascha; Daniel I Sessler Journal: Anesthesiology Date: 2006-10 Impact factor: 7.892
Authors: Vincenzo Mazzaferro; Josep M Llovet; Rosalba Miceli; Sherrie Bhoori; Marcello Schiavo; Luigi Mariani; Tiziana Camerini; Sasan Roayaie; Myron E Schwartz; Gian Luca Grazi; René Adam; Peter Neuhaus; Mauro Salizzoni; Jordi Bruix; Alejandro Forner; Luciano De Carlis; Umberto Cillo; Andrew K Burroughs; Roberto Troisi; Massimo Rossi; Giorgio E Gerunda; Jan Lerut; Jacques Belghiti; Ilka Boin; Jean Gugenheim; Fedja Rochling; Bart Van Hoek; Pietro Majno Journal: Lancet Oncol Date: 2008-12-04 Impact factor: 41.316
Authors: M Gaullier; T Tricard; J Garnon; R-L Cazzato; P Munier; P De Marini; P Werle; V Lindner; A Gangi; H Lang Journal: Prog Urol Date: 2019-12-11 Impact factor: 0.915
Authors: Barbara Biki; Edward Mascha; Denis C Moriarty; John M Fitzpatrick; Daniel I Sessler; Donal J Buggy Journal: Anesthesiology Date: 2008-08 Impact factor: 7.892