Liver Tumor Ablation

What is Liver Tumour Ablation?

Liver tumour ablation is a minimally invasive surgical technique that employs different ablation methods for the purpose of treating primary and secondary liver tumours not amenable to traditional surgery. The technique uses image guidance such as ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scan to pass a needle or probe via the skin into the liver to destroy the tumour instead of surgically removing the tumour.

Some of the common types of liver tumour ablation include:

• Radiofrequency ablation (RFA): This is one of the most common methods of ablation in which a needle or probe is passed through the skin into the liver tumour and then high-frequency electrical currents are transmitted via a probe or electrode in the needle to heat the tumour and destroy cancerous cells.
• Microwave ablation (MWA): This method employs energy from electromagnetic waves or microwaves to heat and eradicate the tumour with a probe.
• Cryoablation (cryotherapy): In this method, a thin metal probe is guided into the tumour and extremely cold temperature is transmitted via the probe to freeze the cancerous tumour.
• Ethanol (alcohol) ablation: The method is also known as percutaneous ethanol injection (PEI) and involves the injection of concentrated alcohol directly into the tumour to destroy cancer cells.

Indications for Liver Tumour Ablation

Some of the indications for liver tumour ablation include:

• The location of the tumour makes surgery risky, such as the tumour being located near the gallbladder or near a crucial blood vessel
• You are not fit enough to have a surgical excision of the tumour
• You have preexisting medical conditions that make surgery risky
• Your tumours are less than 1.5 inches in diameter or cannot be surgically removed
• Hepatocellular carcinoma (HCC), which is a primary liver cancer
• Benign liver lesions
• Colorectal cancer that metastasizes or spreads from the colon or rectum to the liver, which is known as secondary liver cancer

Preparation for Liver Tumour Ablation

Preoperative preparation for liver tumour ablation will involve the following steps:

• A thorough examination by your doctor is performed to check for any medical issues that need to be addressed prior to surgery.
• Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could threaten the safety of the procedure.
• You will be asked if you have allergies to medications, anaesthesia, or latex.
• You should inform your doctor of any medications, vitamins, or supplements that you are taking.
• You should refrain from medications or supplements such as blood thinners, aspirin, or anti-inflammatory medicines several days prior to surgery.
• You should refrain from alcohol or tobacco at least 24 hours prior to surgery.
• You should not consume any solids or liquids at least 8 hours prior to surgery.
• You may be instructed to shower with an antibacterial soap on the morning prior to surgery to reduce the risk of infection.
• Arrange for someone to drive you home as you will not be able to drive yourself after surgery.
• A written consent will be obtained from you after the surgical procedure has been explained in detail.

Procedure Involved in Liver Tumour Ablation

The procedure is performed by an interventional radiologist mostly in an outpatient setting under general or local anaesthesia. A nurse will attach an intravenous line for delivery of medications and fluids and connect monitoring devices to your body to measure blood pressure, heart rate, pulse, and oxygen level during the procedure. Your interventional radiologist then uses an ultrasound scan or a CT scan as guidance to insert a probe or special needle through your skin into the tumour to destroy the cancerous cells. This process may need to be repeated based on the tissue size, location, and number to make sure that all cancerous tissues have been destroyed. Your interventional radiologist will withdraw the probe once the treatment is complete and cover the treatment area with a dressing. The procedure usually takes around one hour or more.

Postoperative Care and Recovery Involved in Liver Tumour Ablation

In general, liver tumour ablation will involve the following postoperative care instructions:

• You will be transferred to the recovery area to be monitored until you are awake from the anaesthesia.
• Your nurse will monitor your vital signs and observe you for any allergic reactions as you recover.
• You will normally require an overnight stay and will be discharged the following day.
• You may experience some pain, swelling, and discomfort in the treatment area. Pain and anti-inflammatory medications and cold packs are recommended as needed.
• Your physician will also provide you with antibiotics to prevent infection.
• Most individuals are able to walk, eat, and drink within a couple of hours post procedure.
• Refrain from smoking for a specific period of time as this may hamper proper healing.
• You should be able to resume all your normal activities in about a week’s time.
• Refrain from strenuous activities and lifting heavy weights for the first couple of weeks. Gradual increase in activities over a period of time is recommended.
• A periodic follow-up appointment will be scheduled to monitor your progress.

Benefits of Liver Tumour Ablation

Some of the benefits of liver tumour ablation include:

• Less expensive than other forms of treatment
• No surgical incision is required, just a small nick on the skin
• Comparatively quick procedure with faster recovery
• Minimal complications and discomfort
• Requires no hospital admission
• High success rate of over 85 per cent in complete removal of small liver tumours

Risks and Complications of Liver Tumour Ablation

Liver tumour ablation is a relatively safe procedure; however, as with any surgery, possible risks and complications may occur, such as:

• Post-procedure pain
• Bowel injury
• Gallbladder inflammation
• Bleeding
• Infection
• Bile leakage
• Liver abscess
• Pneumothorax
• Nausea and vomiting
• Loss of appetite
• Post-ablation syndromes, such as fever or flu-like symptoms