Document Detail


The extent of cryosurgery increases the complication rate after hepatic cryoablation.
MedLine Citation:
PMID:  12716090     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although there have been many reports on the use of cryosurgery to ablate hepatic malignancies none have specifically examined the relationship of complication rates to the extent of cryoablation. A retrospective review from January 1997 to May 2002 identified 98 patients treated with hepatic cryotherapy. The extent of the cryosurgery was determined by the total number of lesions (TNL) and total estimated area (TEA) of the lesions from preoperative evaluation by CT scan and intraoperative evaluation by ultrasound. The major complication rate was 11 per cent. The 30-day mortality was 0 per cent, but the late procedure-related mortality was 2 per cent. Increasing the extent of cryotherapy measured by intraoperative ultrasound demonstrated significant increases in the complication rate and length of stay (LOS). With cryoablation of TEA > or = 30 cm2 there was a significant increase in the overall complication rate (56% vs 23%; P = 0.003) and LOS (8.8 +/- 6.9 vs 6.1 +/- 4.2; P = 0.022) compared with TEA < 30 cm2. Performance of concurrent procedures also led to a significant increase in complications (69% vs 29%; P = 0.010) and LOS (8.6 +/- 6.8 vs 6.0 +/- 4.0; P = 0.019). Multivariate analysis, however, showed intraoperative TEA > or = 30 cm2 to be the most significant independent predictor of increased complications and prolonged LOS.
Authors:
Richard L Sohn; Arthur M Carlin; Christopher Steffes; James G Tyburski; Robert F Wilson; Peter J Littrup; Donald W Weaver
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  69     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-28     Completed Date:  2003-06-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  317-22; discussion 322-3     Citation Subset:  IM    
Affiliation:
Department of Surgery, Wayne State University, Harper University Hospital, Detroit, Michigan 48201, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cryosurgery / adverse effects*,  methods*
Female
Hepatectomy / methods*
Humans
Male
Middle Aged
Postoperative Complications / epidemiology
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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