{Reference Type}: Journal Article
{Title}: Gastrointestinal tract perforation after radiofrequency ablation for hepatic tumor: Incidence and risk factors.
{Author}: Gu K;Kang TW;Han S;Cha DI;Song KD;Lee MW;Rhim H;Park GE;
{Journal}: Eur J Radiol
{Volume}: 177
{Issue}: 0
{Year}: 2024 Jun 11
{Factor}: 4.531
{DOI}: 10.1016/j.ejrad.2024.111560
{Abstract}: <B>OBJECTIVE: </B>We analyzed the incidence and mortality rate of gastrointestinal (GI) tract perforation after radiofrequency ablation (RFA) for hepatic tumors and assess its risk factors.<BR><B>METHODS: </B>This retrospective cohort study included 4799 patients with malignant tumors who underwent RFA (n = 7206). Sixty-nine cases of thermal injury to the GI tract were identified via a search of the electronic medical record system using index terms and divided into two groups according to the thermal injury with (n = 8) or without (n = 61) GI tract perforation based on follow-up CT reports. The risk factors for GI tract perforation were identified via multivariable logistic regression analysis using clinical, technical, and follow-up CT findings.<BR><B>RESULTS: </B>The incidence of thermal injury to the GI tract and GI tract perforation was 0.96 % (69/7206) and 0.11 % (8/7206), respectively. The type of adjacent GI tract and history of diabetes mellitus differed significantly between the two groups (p < 0.05). The index tumor being located around the small intestine was the only significant risk factor for GI tract perforation after ablation (Odds ratio, 22.69; 95 % confidence interval, 2.59-198.34; p = 0.005 [reference standard, stomach]). All perforations were not identified on CT images immediately after RFA. The median time to detection was 20 days (range, 13-41 days). Two patients (25 %, 2/8) died due to perforation-related complications.<BR><B>CONCLUSIONS: </B>GI tract perforation after RFA for hepatic tumors is rare; however, it is associated with high mortality. Thus, careful follow-up is required after RFA if the index tumor is located around the small intestine.