Abstract

Objective: To evaluate complications after consecutive 100 sessions of cone-beam computed tomography (CBCT)-guided radiofrequency ablation (RFA) of lung tumors

Materials and methods: A retrospective study was conducted from January 2016 and October 2018. All procedures were performed using a CBCT virtual navigation guidance system, combining three-dimentional CBCT, needle planning software, and real-time fluoroscopy. Complications were evaluated for each RFA session in 63 consecutive patients (31 male, 32 female; mean age 58.0 years) with 121 lung tumors who underwent 100 sessions of CBCT-guided lung ablation with an internally cooled RFA system. Complications were recorded using the Common Terminology Criteria of Adverse Events (CTCAE) 5.0. A major complication was defined as a grade 3 or 4 adverse event.

Results: There was no postprocedural mortality. The major and minor complication rates were 5% and 28%, respectively. The major complications were significant pulmonary hemorrhage (1%), large hemothorax requiring drainage (1%), pneumonia treated with antibiotics (2%), and delayed bronchopleural fistula (1%). The minor complications were pneumothorax (15%), hemoptysis (11%), and subcutaneous emphysema (2%). Of the 15 pneumothoraces, percutaneous catheter drainage was required in six sessions. Pneumothorax was more likely to occur if RFA was performed on two or more tumors at one session. Immediate, periprocedural and delayed complications were 23%, 9%, and 1%, respectively.

Conclusion: CBCT-guided RFA of lung tumors is a relatively safe procedure with acceptable morbidity.

摘要

目的：评估连续100场锥形束计算机断层扫描（CBCT）引导的肺癌射频消融（RFA）后的并发症

材料和方法：回顾性研究于2016年1月至2018年10月进行。所有程序均使用CBCT虚拟导航指导系统进行，结合了三维CBCT，针头计划软件和实时荧光检查技术。在连续63例患有121例肺部肿瘤的患者中，对每次RFA治疗的并发症进行了评估（其中31例男性，32例女性；平均年龄58.0岁），这些患者接受了100次CBCT引导的采用内部冷却RFA消融的肺部消融术。使用不良事件通用术语标准（CTCAE）5.0记录并发症。主要并发症定义为3级或4级不良事件。

结果：没有术后死亡率。主要和次要并发症发生率分别为5％和28％。主要并发症为明显的肺出血（1％），需要引流的大血胸（1％），用抗生素治疗的肺炎（2％）和延迟的支气管胸膜瘘（1％）。较小的并发症是气胸（15％），咯血（11％）和皮下气肿（2％）。在15例气胸中，有6例需要经皮导管引流。如果在一个疗程中对两个或多个肿瘤进行RFA，则更有可能发生气胸。立即，围手术期和延迟并发症分别为23％，9％和1％。

结论： CBCT指导的RFA肺肿瘤治疗是一种相对安全的方法，具有可接受的发病率。