Case Report
Copyright ©The Author(s) 2020.
World J Gastroenterol. Sep 21, 2020; 26(35): 5375-5386
Published online Sep 21, 2020. doi: 10.3748/wjg.v26.i35.5375
Table 1 Studies reporting gastrointestinal tract injuries after thermal ablation therapies for hepatocellular carcinoma
Ref.Study designNumber of patientsOverall complication rate(%)GIT injury rate (%)Type of GIT injuryThermoablative treatmentTiming of GIT injuryManagement of GIT injuryOutcomeAssociated conditions
Livraghi et al[29], 2003Multicentre, retrospective, questionnaire-based123207.1 (2.42)0.725 colonic perforations; 1 jejunal perforation; 1 gastric perforationPercutaneous RFA2 d-4 dSurgery (7/7)2 deaths after colonic perforationGut wall distance < 1 cm (7/7); adherence due to previous abdominal surgery or inflammatory chronic cholecystitis (6/7); large superficial HCC in left lobe + aggressive treatment (1/7)
De Baere et al[31], 2003Multicentre, prospective131212 (5.72)0.321 colonic perforationRFA34 dSurgeryDeathNA
Curley et al[57], 2004Multicentre, prospective16089.50.1621 stomach wall necrosisOpen RFAImmediateSurgeryRecoveryLeft lobe
Jansen et al[58], 2005Multicentre, prospective11229.8 (6.32)2.5 (02)2 transient paralitic ileusRFA3NASpontaneous resolution (2/2)RecoveryNA
Casaril et al[32], 2007Single-centre, retrospective18325 (7.22)0.721 colonic perforationPercutaneous RFA36 dNADeathSuperficial HCC in Sg4; Child-Pugh B
Kasugai et al[22], 2007Multicentre, retrospective, questionnaire-based26147.920.221 duodenum injury; 1 stomach injury; 1 colonic perforationRFA3NAExternal drainage (1/3)RecoveryNA
Chen et al[34], 2008Single-centre, retrospective11045.220.621 colonic peroration with fistula and abscessPercutaneous RFA3 wkExternal drainageRecoverySuperficial HCC in Sg4; previous surgery for Denver shunt
Liang et al[30], 2009Single-centre, retrospective111362.620.222 colonic perforationsPercutaneous MWA3 d-5 dSurgery (2/2)RecoveryHCC located < 1 cm from colonic wall + prior right partial hepatectomy (2/2)
Livraghi et al[33], 2012Multicentre, retrospective, questionnaire-based173610.2 (2.92)0.221 ileal perforation; 1 colonic perforationPercutaneous MWANASurgery (2/2)RecoverySuperficial HCC in Sg4 + abdominal adhesions (2/2)
Koda et al[53], 2012Multicentre, retrospective, questionnaire-based132833.520.05(0.042)1 colonic perforation; 3 stomach injuries; 2 duodenum injuriesRFA3NASurgery (3/6)1 Death after colonic perforationNA
Ding et al[19], 2013Single-centre, retrospective18798.8-9.4 (3.1-3.52)0.321 bowel perforationPercutaneous RFAImmediateExternal drainageRecoveryPrevious Whipple procedure
Park et al[54], 2017Single-centre, retrospective12116.8 (22)0.221 colonic perforationPercutaneous RFANANARecoveryNA
Jeong et al[28], 2017Single-centre, retrospective13933NA1.32 (0.052)28 stomach injuries; 16 colonic injuries; 6 small bowel injuries; 1 small bowel perforation; 1 colonic perforationPercutaneous RFA2 d-13 d (perforations)Surgery (2/2 perforations)RecoverySubcapsular HCC (47/52); previous percutaneous treatments (7/52) or abdominal surgery (19/52)
Maeda et al[59], 2020Multicentre, retrospective, questionnaire based94113.520.0422 colonic perforationsNANANA1 DeathNA