Name of the Procedure:

Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency
Common names: Radiofrequency Ablation (RFA) for Liver Tumors

Summary

Radiofrequency Ablation (RFA) for liver tumors involves using heat generated by radio waves to destroy cancerous cells in the liver. This minimally invasive procedure is performed through the skin (percutaneously) using a needle-like probe to target and treat one or more liver tumors.

Purpose

RFA is used to treat liver cancer or tumors that cannot be removed through surgery. The goal is to destroy cancer cells, reduce tumor size, alleviate symptoms, and potentially prolong the patient's life. It may also be used to control tumor growth while waiting for a liver transplant.

Indications

• Patients with primary liver cancer (hepatocellular carcinoma) or metastatic liver tumors.
• Tumors that are 5 cm or smaller.
• Patients who cannot undergo surgery due to other health conditions.
• Patients with limited liver tumors who require a minimally invasive treatment.

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments may be required for existing medications, particularly blood thinners.
• Pre-procedure imaging tests, such as an ultrasound, CT scan, or MRI, are needed to locate tumors precisely.

Procedure Description

1. The patient lies on the procedure table, and local anesthetic is administered to the skin area over the liver.
2. Using imaging guidance, such as ultrasound or CT, the physician inserts a thin, needle-like probe through the skin and into the liver tumor.
3. Radiofrequency energy is sent through the probe, generating heat to destroy the tumor cells.
4. The procedure targets and treats each tumor individually.
5. The probe is removed, and a bandage is applied to the insertion site.

Duration

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

Setting

RFA is usually performed in a hospital or specialized outpatient clinic equipped with the necessary imaging technology.

Personnel

• Interventional Radiologist or Hepatologist
• Nurses and Radiology Technicians
• Anesthesiologist if general anesthesia is required

Risks and Complications

• Common: Pain, fever, bleeding at the insertion site.
• Rare: Infection, damage to adjacent organs or blood vessels, liver abscess, and pneumothorax (collapsed lung).
• Management includes antibiotics for infection, pain relief medications, and supportive care.

Benefits

• Minimally invasive with a shorter recovery time compared to traditional surgery.
• Effective at destroying small tumors and alleviating symptoms.
• Patients may experience relief from symptoms within a few days to weeks post-procedure.

Recovery

• Observation for a few hours post-procedure to monitor for complications.
• Pain management as needed, typically with over-the-counter medications.
• Restrictions may include avoiding heavy lifting or strenuous activities for a few days.
• Follow-up imaging tests and appointments to monitor the treatment's effectiveness.

Alternatives

• Surgical resection: Surgically removing part of the liver containing the tumor(s).
• Transarterial Chemoembolization (TACE): Delivering chemotherapy directly to the tumor.
• Systemic chemotherapy or targeted therapy medications.
• Each alternative has its own set of risks, benefits, and indications, which should be discussed with the healthcare provider.

Patient Experience

• Patients may feel some discomfort or pressure during needle insertion, but pain is generally well-managed with local anesthesia.
• Post-procedure, some soreness at the insertion site and mild flu-like symptoms may occur.
• Most patients can resume normal activities within a few days after the procedure. Regular follow-up appointments are crucial to monitor the liver's condition and overall health.