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肺癌微波消融:并发症

时间:2020-03-02 22:39来源:未知 作者:admin 点击:
None Mild Moderate Severe Life- Th r eaten i ng Death Pneumothorax 73 (68%) 14 (13%) 16 (15%) 4 (4%) 0 1(1%) Hospital Admission 78 (72%) 14 (13%) 9 (8%) 6 (6%) 1(1%) 2 (2%) BPF 105 (97%) 0 0 1(1%) 1(1%) 1(1%) Pain 85 (78%) 19 (18%) 3 (3%)

Pneumothorax
32.4% (35/108) of patients
86% (30/35) experienced grade 1 (no chest tube  required) or grade 2 (8 French pigtail chest tube  required, without hospital admission)
No relationship with tumor size or antenna #
Hospital Admission
28% (30/108) of patients
77% (23/30) required less than a 72 hour stay
 


No intraprocedural deaths
2 serious (Grade 4 or higher) intraprocedural AEs
- 73 yo male developed intraprocedural hemothorax  requiring transfusion and thoracotomy
           d/c from hospital 5 days later without further  complication

- 76 yo male developed intraprocedural PTX leading  to respiratory arrest and hypoxia requiring  intubation
          PTX treated with a chest tube, d/c 6 days later without  further complication
 

 

None

Mild

Moderate

Severe

Life-  Threatening

Death

Pneumothorax

73 (68%)

14(13%)

16 (15%)

4 (4%)

0

1(<1%)

Hospital Admission

78 (72%)

14(13%)

9 (8%)

6 (6%)

1(<1%)

2 (2%)

BPF

105 (97%)

0

0

1(<1%)

1(<1%)

1(<1%)

Pain

85 (78%)

19(18%)

3 (3%)

0

0

1(<1%)

Infection/COPD  
exacerbation

102 (94%)

1(<1%)

5 (5%)

0

1(<1%)

0

ARDS/hypoxia

105(97%)

0

0

0

1(<1%)

2 (2%)

Post-ablation

104

4 (4%)

0

0

0

0

Syndrome

(96%)

 

 

 

 

 



































 

2 deaths within 30 days of ablation

- 57 yo female admitted for overnight  observation due to persistent chest wall pain  post procedure
          Received a large dose of narcotics overnight and  aspirated, leading to ARDS and death 48 hrs later

- 88 yo female with a persistent PTX due to an underlying BPF
          Developed a multifocal hospital-acquired  pneumonia leading to ARF and death after 7 days



安全性的讨论
 
30 day mortality rate of 1.9% similar to ablation  and surgical literature
PTX rate of 32% is similar to prior MWA and RFA  literature
- 40% (14/35) required no chest tube placement
- No relationship with number of antenna
-72% of patients treated safely as an outpatient
- Of the 30 patients that required admission, 47% were  discharged within 24 hours and 77% within 72 hours
First study to report BPF due to MWA
 
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