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World J Hepatol. Mar 27, 2014; 6(3): 107-113
Published online Mar 27, 2014. doi: 10.4254/wjh.v6.i3.107
Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors
Alexandre Zanchenko Fonseca, Stephanie Santin, Luiz Guilherme Lisboa Gomes, Jaques Waisberg, Marcelo Augusto Fontenelle Ribeiro Jr.
Alexandre Zanchenko Fonseca, Stephanie Santin, Marcelo Augusto Fontenelle Ribeiro Jr., Department of General Surgery, University of Santo Amaro, São Paulo, SP CEP 04702-001, Brazil
Luiz Guilherme Lisboa Gomes, Jaques Waisberg, Department of General and Digestive Surgery, ABC Medical School, Santo André, SP 04601-060, Brazil
Author contributions: Santin S and Gomes LGL performed the research; Fonseca AZ, Ribeiro Jr. MAF and Waisberg J wrote the paper.
Correspondence to: Alexandre Zanchenko Fonseca, MD, Department of General Surgery, University of Santo Amaro, Rua Teixeira da Silva, 34 cj 41 - Paraíso, São Paulo, SP CEP 04002030, Brazil.
Telephone: +55-11-32512469 Fax: +55-11-32846892
Received: October 27, 2013
Revised: December 9, 2013
Accepted: January 15, 2014
Published online: March 27, 2014

Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe. Thus, complications occur and vary widely in the literature. Complications are caused by thermal damage, direct needle injury, infection and the patient’s co-morbidities. Tumor type, type of approach, number of lesions, tumor localization, underlying hepatic disease, the physician’s experience, associated hepatic resection and lesion size have been described as factors significantly associated with complications. The physician in charge should promptly recognize high-risk patients more susceptible to complications, perform a close post procedure follow-up and manage them early and adequately if they occur. We aim to describe complications from RFA of hepatic tumors and their risk factors, as well as a few techniques to avoid them. This way, others can decrease their morbidity rates with better outcomes.

Keywords: Radiofrequency ablation, Hepatic tumors, Complications, Risk factors, Hepatocellular carcinoma

Core tip: This article is an interesting and updated compilation of the complications of radiofrequency ablation of liver tumors. Several complications are described, as well as their risk factors and incidence. Some strategies to avoid them from happening are also reported.