September 28, 2012

Ablation Techniques


Radiofrequency ablation (RFA) therapy / radio frequency ablation therapy

In the U.S., RFA therapy has become the choice of therapy ablation (destruction or destruction of tissue) between surgeons. Surgeons can perform this procedure laparoscopically (through small holes in the abdomen) or during exploration (exploration) open the abdomen. In some instances, the procedure can be performed without opening the abdomen by just using ultrasound for visual guidance.


In RFA, heat is generated locally by an alternating electric current (AC) high frequency flowing from the electrodes. A probe is inserted into the center of the tumor and the electrodes are not isolated, which is shaped like the teeth of a fork, projected into the tumor. Local heat generated melts the tissue (coagulative necrosis) adjacent to the probe. The probe was left in place for approximately 10 to 15 minutes. The entire procedure is monitored visually by ultrasound scanning. The ideal size of an HCC tumor for RFA is less than 3 cm. Tumors larger may require more than one session. This treatment should be seen as a relieve / alleviate, not cure.


Percutaneous ethanol (alcohol) injection

In this technique, pure alcohol is injected into the tumor through a thin needle with the help of ultrasound or CT visual guidance. Alcohol induces destruction / eradication of tumor by pulling water out of the tumor cells (dehydrating them to) and thus change (changing the nature of) the structure of cell proteins. It may take five or six sessions of injections to eradicate cancer completely. The ideal patient for alcohol injection experiences a less than three HCC tumors, each of them is:

• well-defined (clear boundaries)
• less than 3 cm in diameter
• surrounded by a capsule / shell consisting of scar tissue (fibrous encapsulation)
• not near the surface of the liver

In addition, patients with liver cancer who underwent alcohol ablation should not have signs of chronic liver failure, such as ascites or jaundice. Patients with liver failure will not be able to tolerate the alcohol injections.

The side effects alcohol injections of the most common is leakage of alcohol on the liver surface and into the abdominal cavity, thus causing pain and fever. It is important that the location of the tumor relative to blood vessels and bile ducts adjacent clearly identified. Because for the purposes of localizing these structures is to avoid injuring them during the procedure and causing bleeding, inflammation of vessels / bile ducts, or bile leakage.


Proton beam therapy

This technique is able to deliver radiation doses that are high on a local area defined. Proton beam therapy is also used in the treatment of solid tumors other. Still not a lot of data about the efficacy of this treatment on liver cancer. The ideal patient is one with only a small wound (less than 5 cm) are isolated. To do this procedure, the patient is actually fitted with a mold body so he can be placed in the same position for each session. Therapy carried out every day for 15 days. Preliminary data from the U.S. suggest similar effectiveness as seen with TACE or ablation therapy. It is not known, however, whether this type of radiation treatment prolong patients' lives.

Comparing medical care procedures that are diverse from one another. We really do not know because there are no studies comparing head to head chemotherapy (chemotherapy), chemoembolization, ablation techniques, and proton beam therapy with one another. Most of the reports dealing with a group of heterogeneous (different) from patients who had undergone only one specific procedure or other treatment. Therefore, the choice of a treatment option for a particular patient will depend primarily on the expertise of doctors in patient areas. Studies are also needed to evaluate combinations of these procedures (eg, proton beam and TACE). Now, what about surgery?
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Ablation Techniques


Radiofrequency ablation (RFA) therapy / radio frequency ablation therapy

In the U.S., RFA therapy has become the choice of therapy ablation (destruction or destruction of tissue) between surgeons. Surgeons can perform this procedure laparoscopically (through small holes in the abdomen) or during exploration (exploration) open the abdomen. In some instances, the procedure can be performed without opening the abdomen by just using ultrasound for visual guidance.


In RFA, heat is generated locally by an alternating electric current (AC) high frequency flowing from the electrodes. A probe is inserted into the center of the tumor and the electrodes are not isolated, which is shaped like the teeth of a fork, projected into the tumor. Local heat generated melts the tissue (coagulative necrosis) adjacent to the probe. The probe was left in place for approximately 10 to 15 minutes. The entire procedure is monitored visually by ultrasound scanning. The ideal size of an HCC tumor for RFA is less than 3 cm. Tumors larger may require more than one session. This treatment should be seen as a relieve / alleviate, not cure.


Percutaneous ethanol (alcohol) injection

In this technique, pure alcohol is injected into the tumor through a thin needle with the help of ultrasound or CT visual guidance. Alcohol induces destruction / eradication of tumor by pulling water out of the tumor cells (dehydrating them to) and thus change (changing the nature of) the structure of cell proteins. It may take five or six sessions of injections to eradicate cancer completely. The ideal patient for alcohol injection experiences a less than three HCC tumors, each of them is:

• well-defined (clear boundaries)
• less than 3 cm in diameter
• surrounded by a capsule / shell consisting of scar tissue (fibrous encapsulation)
• not near the surface of the liver

In addition, patients with liver cancer who underwent alcohol ablation should not have signs of chronic liver failure, such as ascites or jaundice. Patients with liver failure will not be able to tolerate the alcohol injections.

The side effects alcohol injections of the most common is leakage of alcohol on the liver surface and into the abdominal cavity, thus causing pain and fever. It is important that the location of the tumor relative to blood vessels and bile ducts adjacent clearly identified. Because for the purposes of localizing these structures is to avoid injuring them during the procedure and causing bleeding, inflammation of vessels / bile ducts, or bile leakage.


Proton beam therapy

This technique is able to deliver radiation doses that are high on a local area defined. Proton beam therapy is also used in the treatment of solid tumors other. Still not a lot of data about the efficacy of this treatment on liver cancer. The ideal patient is one with only a small wound (less than 5 cm) are isolated. To do this procedure, the patient is actually fitted with a mold body so he can be placed in the same position for each session. Therapy carried out every day for 15 days. Preliminary data from the U.S. suggest similar effectiveness as seen with TACE or ablation therapy. It is not known, however, whether this type of radiation treatment prolong patients' lives.

Comparing medical care procedures that are diverse from one another. We really do not know because there are no studies comparing head to head chemotherapy (chemotherapy), chemoembolization, ablation techniques, and proton beam therapy with one another. Most of the reports dealing with a group of heterogeneous (different) from patients who had undergone only one specific procedure or other treatment. Therefore, the choice of a treatment option for a particular patient will depend primarily on the expertise of doctors in patient areas. Studies are also needed to evaluate combinations of these procedures (eg, proton beam and TACE). Now, what about surgery?