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Hepatocellular carcinoma and liver metastases: clinical data on a new dual-lumen catheter kit for surgical sealant infusion to prevent perihepatic bleeding and dissemination of cancer cells following biopsy and loco-regional treatments.

Izzo F, Palaia R, Albino V, Amore A, di Giacomo R, Piccirillo M, Leongito M, Nasto A, Granata V, Petrillo A, Lastoria S - Infect. Agents Cancer (2015)

Bottom Line: RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications.No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.

View Article: PubMed Central - PubMed

Affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.

ABSTRACT

Background: RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications. The most common reported complications include abdominal hemorrhage, bile leakage, biloma formation, hepatic abscesses, and neoplastic seeding. The aim of this study is to evaluate the feasibility of percutaneous use of surgical sealant with a new coaxial bilumen catheter, to prevent the perihepatic bleeding and dissemination of cancer cells through the needle-electrode (neoplastic seeding) or along the needle track.

Methods: We designed a novel dual-lumen catheter to facilitate the optimal application of fibrin sealant after diagnostic and therapeutic percutaneous procedures. Percutaneous RFA has been performed using mask ventilation or neuroleptanalgesia. The main aims of this study, after the ablation procedure, in the treatment of unresectable liver cancer were to prevent major adverse events: a) the perihepatic bleeding; b) dissemination of cancer cells through the needle-electrode and or needle track.

Results: A total of 181 patients were evaluated for this study at National Cancer Institute of Naples from January 2012 to January 2014. The association of blood loss (≤1 g/dl; ≥1 g/dl) with age, gender, histological diagnosis were analyzed. No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.

Conclusions: This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.

No MeSH data available.


Related in: MedlinePlus

Macroscopic evidence (in a specimens post liver resection) where is evident the presence of the sealant inside the tumor and along the needle-track.
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Fig5: Macroscopic evidence (in a specimens post liver resection) where is evident the presence of the sealant inside the tumor and along the needle-track.

Mentions: In our study, the procedure was completed in all cases and no laparotomy or angiographic procedure were necessary to achieve hemostasis. The interventions (FNA and RFA) were not associated with complications as anticipated including biloma, hepatic abscess, and bile duct injury. The absence of these complications typically associated with the two interventions, was confirmed by clinical and radiological follow-up (median 18 months) (Figures 4 and 5). Blood tests did not reveal any abnormal coagulation parameters after the procedure. The kit was easy to use and the application of the fibrin sealant did not pose any particular technical problems. The fibrin sealant could be applied correctly: the two sealant components were mixed correctly at 37°C and at the proper time ensuring the optimal application of active hemostatic agent at the treated liver sites.Figure 4


Hepatocellular carcinoma and liver metastases: clinical data on a new dual-lumen catheter kit for surgical sealant infusion to prevent perihepatic bleeding and dissemination of cancer cells following biopsy and loco-regional treatments.

Izzo F, Palaia R, Albino V, Amore A, di Giacomo R, Piccirillo M, Leongito M, Nasto A, Granata V, Petrillo A, Lastoria S - Infect. Agents Cancer (2015)

Macroscopic evidence (in a specimens post liver resection) where is evident the presence of the sealant inside the tumor and along the needle-track.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4403704&req=5

Fig5: Macroscopic evidence (in a specimens post liver resection) where is evident the presence of the sealant inside the tumor and along the needle-track.
Mentions: In our study, the procedure was completed in all cases and no laparotomy or angiographic procedure were necessary to achieve hemostasis. The interventions (FNA and RFA) were not associated with complications as anticipated including biloma, hepatic abscess, and bile duct injury. The absence of these complications typically associated with the two interventions, was confirmed by clinical and radiological follow-up (median 18 months) (Figures 4 and 5). Blood tests did not reveal any abnormal coagulation parameters after the procedure. The kit was easy to use and the application of the fibrin sealant did not pose any particular technical problems. The fibrin sealant could be applied correctly: the two sealant components were mixed correctly at 37°C and at the proper time ensuring the optimal application of active hemostatic agent at the treated liver sites.Figure 4

Bottom Line: RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications.No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.

View Article: PubMed Central - PubMed

Affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.

ABSTRACT

Background: RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications. The most common reported complications include abdominal hemorrhage, bile leakage, biloma formation, hepatic abscesses, and neoplastic seeding. The aim of this study is to evaluate the feasibility of percutaneous use of surgical sealant with a new coaxial bilumen catheter, to prevent the perihepatic bleeding and dissemination of cancer cells through the needle-electrode (neoplastic seeding) or along the needle track.

Methods: We designed a novel dual-lumen catheter to facilitate the optimal application of fibrin sealant after diagnostic and therapeutic percutaneous procedures. Percutaneous RFA has been performed using mask ventilation or neuroleptanalgesia. The main aims of this study, after the ablation procedure, in the treatment of unresectable liver cancer were to prevent major adverse events: a) the perihepatic bleeding; b) dissemination of cancer cells through the needle-electrode and or needle track.

Results: A total of 181 patients were evaluated for this study at National Cancer Institute of Naples from January 2012 to January 2014. The association of blood loss (≤1 g/dl; ≥1 g/dl) with age, gender, histological diagnosis were analyzed. No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.

Conclusions: This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.

No MeSH data available.


Related in: MedlinePlus