Serkan ARIBAL, Eyüp KAYA

Amaç: Çalışmamızda karaciğer metastazlarında ultrason eşliğinde yapılan mikrodalga ablasyon tedavisi sonrası gelişen lokal nüksün karaciğer kapsülü ve ablasyon traktı ile ilgili özelliklerinin değerlendirlmesi amaçlanmıştır. Yöntemler: Şubat 2016 ile Aralık 2019 tarihleri arasında mevcut karaciğer metastazına US rehberliğinde perkutan mikrodalga abalasyon tedavisi yapılan 101 olgu retrospektif olarak değerlendirildi. Toplam 32 lokal nükse sahip ablate lezyonu bulunan 19 hasta çalışmaya dahil edildi. Metastazların histopatolojik tipleri, ablasyon öncesi özellikleri ve ablasyon işlemine ait bilgiler not edildi. Tümörün boyutları ve tümör ile karaciğer kapsülü arasındaki en kısa mesafe ölçüldü. Lokal nüksün karaciğer kapsülüne ve ablasyon tarktına göre tarafı ve yerleşimi ile şekil özellikleri değerlendirildi. Bulgular: Ortanca lokal nükssüresi 8.46±4.54 ay (3-20 aralığında) olarak bulundu. Hasta ve lezyon bağımlı lokal nüks oranları sırasıyla 19% ve 20% idi. Parankim içi yerleşimli lezyonlara ait lokal nükslerin tümü ablasyon traktının ucu ya da yanında yerleşimli olarak bulundu ve bu ilişki istatistiksel olarak anlamlıydı (p=0.035). Damar yakınlığı ile lokal nüksün şekli ve lokal nüksün tarafı ile şekli arasında istatistiksel olarak anlamlı ilişki saptanmadı (sırasıyla p=0.704 ve 0.683). Sonuç: Çalışmamızda parankimal yerleşimli lezyonlardan gelişen lokal rekürrensin hepsinin ablasyon traktının uç ve yan kesimlerinden geliştiği ortaya konulmuştur. Ayrıca lokal rekürrensin karaciğer kapsülü ve ablasyon traktı ile ilişkili bir takım özellikleri ve bu bulguların birbiri ile ilgili ilişkileri ortaya konuldu.

Anahtar Kelimeler:

Lokal rekurrens, mikrodalga ablasyon, ablasyon trakt, karaciğer metastazları, karaciğer kapsülü

Capsule and Ablation Tract Related Features of Local Recurrence in Ultrasound Guided Microwave Ablation of Liver Metastases

Aim: To evaluate the capsule and ablation tract related features of local recurrence after ultrasound (US) guided percutaneous microwave ablation (MWA) of the liver metastases independently. Methods: Between February 2016 and December 2019, 101 patients with US-guided percutaneous MWA of the liver metastases were analyzed. Nineteen patients having thirty-two ablated lesions with local recurrence (LR) were included in the study. Histopathologic type of tumor, preablative features of the lesions and the ablation procedure data were noted. Tumor size, the closest distance between the lesion and the liver capsule was measured. The site of LR related to the liver capsule and related to ablation tract and the shape of the LR were noted Results: The median time of LR was 8.46±4.54 months (range, 3-20). The patient (n=19) and the ablated lesion (n=32) depended LR rates were 19% and 20% respectively. All LR of the parenchymal localized metastatic lesions originated from either tip or the side of the ablation tract and this relationship was found as statistically significant (p=0.035). no statistically significant relationship was found between vessel closeness and shape of LR (p=0,704) and between the site and the shape of LR (p=0.683). Conclusion: We defined some features of LR related to the ablation tract and liver capsule independently such as the relation between the recurrence and the blood vessel proximity, side of the LR throughout the ablation tract and its relation with the liver capsule.

Keywords:

Local recurrence ultrasound, Microwave ablation, Ablation tract, Liver metastasis, Liver capsule,

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