32998 Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; radiofrequency

Name of the Procedure:

Ablation Therapy for Reduction or Eradication of Pulmonary Tumors (Radiofrequency Ablation)

Summary

Radiofrequency ablation (RFA) is a minimally invasive procedure used to destroy pulmonary tumors using heat generated by radio waves. It involves inserting a needle-like probe through the skin into the tumor, guided by imaging technology, to deliver the radiofrequency energy that heats and destroys cancer cells.

Purpose

RFA is used to treat lung cancer and metastatic tumors in the lungs, especially when surgery is not an option. The goal is to reduce or eliminate tumor growth, alleviate symptoms, and improve the patient's quality of life.

Indications

• Patients with primary lung cancer or metastatic lung tumors that cannot be surgically removed.
• Patients with limited lung function or other health conditions that preclude surgery.
• Tumors confined to one side of the chest affecting the lungs, pleura, or chest wall.

Preparation

• The patient may need to fast for several hours before the procedure.
• Medication adjustments may be necessary, including stopping blood thinners.
• Pre-procedure assessments may include blood tests, imaging studies (CT scan or MRI), and a review of the patient's medical history.

Procedure Description

1. The patient is positioned, and local anesthesia or sedation is administered.
2. Using imaging guidance (CT or ultrasound), the physician inserts a thin, needle-like probe through the skin and into the tumor.
3. The probe delivers radiofrequency energy, creating heat that destroys the cancer cells.
4. Thermal sensors in the probe monitor and regulate the temperature to ensure effective ablation.
5. Once the tumor tissue is ablated, the probe is removed.

Duration

The procedure typically takes 1 to 3 hours, depending on the number and size of tumors.

Setting

RFA is usually performed in a hospital interventional radiology suite or a specialized outpatient clinic.

Personnel

• Interventional radiologist or thoracic surgeon
• Radiology technologist
• Anesthesiologist or nurse anesthetist
• Nurses and support staff

Risks and Complications

• Common: Mild pain or discomfort, localized bruising, and risk of infection at the insertion site.
• Rare: Pneumothorax (collapsed lung), bleeding, damage to nearby tissues, and possible incomplete tumor ablation.

Benefits

• Minimally invasive with a shorter recovery time compared to surgery.
• Preserves more lung function and is suitable for patients with limited lung capacity.
• Can effectively reduce or eliminate tumors, providing symptom relief and potentially extending survival.

Recovery

• Post-procedure monitoring in a recovery area for a few hours.
• Patients may experience mild pain or discomfort, managed with medication.
• Most can resume normal activities within a few days.
• Follow-up imaging studies to monitor the effectiveness of the ablation.

Alternatives

• Surgical resection of tumors
• Other ablation methods (e.g., cryoablation, microwave ablation)
• Radiation therapy or chemotherapy
• Pros: Surgery may offer a more definitive cure.
• Cons: Surgery and other methods may be more invasive and have longer recovery times.

Patient Experience

During the procedure, patients may feel mild pressure or heat but should not experience significant pain due to anesthesia. After the procedure, there might be soreness or discomfort at the insertion site, which can be managed with pain medication. Patients typically recover quickly and can return to daily activities within a few days, with ongoing follow-up to monitor the treatment's success.