Ethanol Ablation for Odontogenic myxoma: New alternative of conservative treatment

Odontogenic myxoma is a maxillofacial tumor that is benign in nature. It is characterized by a slow-growing, painless, and site-aggressive behavior. A main feature is that it is not encapsulated so it has high potential of invasiveness and penetration into peripheral tissues. Large lesions may cause extensive compromise of the region. Treatment strategy for Odontogenic Myxoma is still controversial. Radical resection with an appropriate surgical margin is recommended, but emerging evidence has suggested that a more conservative approach will result in less morbidity and adequate results. This report shows a remarkable result on a 16-year-old patient who had a Mandibular Odontogenic Myxoma treated with a conservative approach. Intra-lesional absolute alcohol irrigation was performed during a 5-month period. Considerable volume reduction of the lesion happened which allowed a minimal overall resection. No recurrence was found after a 3 year follow-up.

Efficacy and safety of microwave ablation combined with systemic chemotherapy in treatment of recurrent intrahepatic cholangiocarcinoma / 临床肝胆病杂志

Objective To investigate the efficacy and safety of microwave ablation (MWA) combined with chemotherapy versus MWA alone in the treatment of recurrent intrahepatic cholangiocarcinoma (RICC). Methods A retrospective cohort study was conducted among the patients with RICC who received MWA+chemotherapy or MWA in The Second People's Hospital of Neijiang and The Affiliated Hospital of Southwest Medical University from January 2014 to March 2021, and their clinicopathological data were collected. The independent samples t -test was used for comparison of continuous data, and the chi-square test and the Fisher's exact test were used for comparison of categorical data. The Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS), and the Log-rank test was used for comparison of survival differences. Univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the risk factors for survival and prognosis. Results A total of 106 patients with RIC were enrolled, among whom there were 55 patients in the MWA+chemotherapy group and 51 in the MWA group. By the end of follow-up, the MWA+chemotherapy group had a median PFS of 15.0 months (95% confidence interval [ CI ]: 14.5-15.5), and the MWA group had a median PFS of 13.4 months (95% CI : 11.6-15.2), with a significant difference between the two groups ( χ 2 =9.624, P =0.002). The MWA+chemotherapy group had a median OS of 21.0 months (95% CI : 20.0-21.8), and the MWA group had a median OS of 18.0 months (95% CI : 16.3-19.7), with a significant difference between the two groups ( χ 2 =12.784, P 5 cm, time to recurrence < 1 year, and absence of systemic chemotherapy tend to have a poor prognosis.

Intervencionismo para el control del dolor por metástasis óseas / Interventionism for pain control due bone metastases

Objetivo: El dolor óseo por cáncer óseo o metástasis es un dolor de difícil manejo asociado a dolor incidental. Hay distintas estrategias quirúrgicas para su tratamiento, sin embargo, no todos los pacientes con metástasis óseas pueden beneficiarse de un tratamiento quirúrgico. La presente revisión bibliográfica tiene como objetivo identificar terapias intervencionales mínimamente invasivas para el control del dolor por metástasis óseas. Métodos: Revisión bibliográfica acerca de terapias intervencionales para el control del dolor por metástasis óseas utilizando la base de datos PubMed (www.pubmed.gov) y el motor de búsqueda Google (www.google.cl). Tipos de participantes: Pacientes con metástasis óseas dolorosas de cualquier tumor primario. Tipos de intervenciones: Bloqueos anestésicos, bloqueos neurolíticos, terapias ablativas, cementoplastías. Resultados: Se obtuvieron 384 resultados que incluyeron revisiones sistemáticas, revisiones bibliográficas, ensayos clínicos controlados, series de casos y reporte de casos. Todos los artículos relevantes en inglés y español se incluyeron para su análisis. Conclusión: Las metástasis óseas son un evento común en los pacientes con cáncer, y el dolor óseo es un dolor de difícil manejo asociado a dolor incidental. Se han desarrollado terapias intervencionales no invasivas o mínimamente invasivas para tratar el dolor, mejorar la calidad de vida y la funcionalidad, disminuir el consumo de fármacos, y reducir el tamaño del tumor. La gran mayoría ha demostrado ser terapias seguras y eficaces, con pocos eventos adversos y de rápida resolución, y que si son combinadas mejoran los resultados.

Objective: Bone pain from bone cancer or metastasis is a pain that is difficult to manage associated with incidental pain. There are different surgical strategies for its treatment, however, not all patients with bone metastases can benefit from a surgical treatment. This literature review aims to identify minimally invasive interventional therapies for the control of pain due to bone metastasis. Methods: Literature review of interventional therapies for the control of pain due to bone metastases was done using the PubMed database (www.pubmed.gov) and the Google search engine (www.google.cl). Types of participants: Patients with painful bone metastases from any primary tumor. Types of interventions: Anesthetic blocks, neurolytic blocks, ablative therapies, cementoplasties. Results: We obtained 384 results that included systematic reviews, literature reviews, controlled clinical trials, case series and case reports. All relevant articles in English and Spanish were included for analysis. Conclusion: Bone metastases are a common event in cancer patients, and bone pain is a difficult-to-manage pain associated with incidental pain. Non-invasive or minimally invasive interventional therapies have been developed to treat pain, improve quality of life and functionality, decrease drug use, and reduce tumor size. The vast majority therapies have been shown to be safe and effective ones, with few adverse events and rapid resolution, and that if combined they improve the outcomes.

Can concomitant bladder neck incision and primary valve ablation reduce early re-admission rate and secondary intervention?

ABSTRACT Objective: To assess the effect of bladder neck morphology and its incision (BNI) in patients with posterior urethral valve (PUV) on early reintervention rate. Patients and methods: Infants undergoing PUV ablation (PVA) before 24 months of age and had at least 18 months of follow-up, were categorized into three groups according to the bladder neck appearance on baseline radiological and endoscopic examination: group 1; normal bladder neck underwent PVA, group 2; high bladder neck underwent PVA plus BNI, group 3; high bladder neck underwent PVA only. Early reintervention was defined as the need for check cystoscopy because of persistent renal function deterioration, worsening hydronephrosis and/or unsatisfactory VCUG improvement during the 1st six months post primary PVA. Results: Between 2000 and 2017, a total of 114 patients underwent PVA and met the study criteria with a median follow-up of 58 (18-230) months. For group 1, 16 (22.9%) patients needed readmission. Check cystoscopy was free and no further intervention was performed in 5(7.5%) and re-ablation was performed in 11(15.7%) patients. For group 2, 3(14.3%) patients needed reintervention. Re-ablation and re-ablation plus BNI were performed in 1(4.8%) and 2(9.5%), respectively. For group 3, cystoscopy was free in 1(4.3%), re-ablation and re-ablation plus BNI were performed 2(8.7%) and 1(4.3%), respectively. There were no significant differences in the re-admission and re-intervention rates among the three study groups (p=0.65 and p=0.50, respectively). Conclusion: In morphologically high bladder neck associated PUV, concomitant BNI with PVA doesn't reduce early re-intervention rate.

Influencing factors of endoscopic radiofrequency ablation complications for malignant biliary obstruction / 中华肝胆外科杂志

Objective:To study the influencing factors of postoperative complications in patients with malignant biliary obstruction treated by endoscopic radiofrequency ablation(RFA).Methods:Data of patients with malignant biliary obstruction who underwent endoscopic RFA at the Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine from January 2010 to June 2021 were retrospectively analyzed. There were 62 males and 48 females, with age (74.1±11.1) years. Based on occurrence of postoperative complications, these patients were divided into the complication group ( n=18) and the control group ( n=92). Univariate and multivariate logistic regression analysis were used to analysis the influencing factors of complications. Results:RFA was successfully performed in 110 patients with malignant biliary obstruction, and the technical success rate was 100.0% (110/110). Postoperative complications occurred in 18 patients (16.4%), including 12 patients with of biliary tract infection (8 patients with acute cholangitis, 4 patients with acute cholecystitis) and 6 patients with acute pancreatitis. All these patients responded well to treatment. The proportion of patients who developed complications having associated diabetes, bile duct stenosis length >2.5 cm, fractional RFA for bile duct stenosis, and single stent drainage were significantly higher than those in the control group (all P<0.05). Multivariate logistic regression analysis showed that the risk of complications after endoscopic RFA was significantly increased in patients with diabetes ( OR=6.967, 95% CI: 1.256-38.658) and fractional RFA of bile duct stenosis ( OR=8.297, 95% CI: 1.526-45.122), while the risk of complications after multiple stents drainage ( OR=0.037, 95% CI: 0.008-0.169) was significantly decreased (all P<0.05). Conclusion:Diabetes and fractional RFA of bile duct stenosis were risk factors for complications after endoscopic RFA of malignant biliary obstruction. Multiple stents drainage was a protective factor. Better clinical attention should be paid to the patients with high risk factors.

Application value of contrast-enhanced ultrasound before and after microwave ablation of thyroid nodules / 中国基层医药

Objective:To investigate the application value of contrast-enhanced ultrasound (CEUS) before and after microwave ablation of thyroid nodules.Methods:Fifty-six patients (79 thyroid nodules) who received microwave ablation of thyroid nodules in Huaian Medical District, General Hospital of Eastern Theater Command from March 2016 to October 2019 were included in this study. CEUS was performed before microwave ablation to accurately assess the size, number and blood supply of thyroid nodules as well as the position of the feeding vessels. CEUS was performed immediately after microwave ablation to determine whether the lesion area was thoroughly ablated and to measure the volume of thyroid nodules. At 1, 3, 6 and 12 months after surgery, the level of thyroid hormone was measured and the absorption of thyroid nodules was evaluated.Results:Preoperative CEUS showed that among the 79 thyroid nodules, 42 were solid nodules that had different degrees of enhancement, including 33 annular homogeneously highly enhanced nodules and 9 heterogeneously highly enhanced nodules; 24 were cystic mixed solid nodules that had solid components, including 16 homogeneously highly enhanced nodules and 8 nodules with only local high enhancement in the solid component; 13 were cystic nodules, including 9 nodules with septa and 3 nodules with contrast medium on the diaphragm. Contrast medium was still visible around three nodules immediately after microwave ablation. Ablation continued in three nodules until there was no contrast medium. The incidence of complications during and after treatment was 0%. The average volume of the thyroid nodules before treatment was (7.52 ± 6.74) cm3. At 1, 3, 6 and 12 months after surgery, the average volume of the thyroid nodules was (6.06 ± 5.19) cm3, (3.06 ± 2.85) cm3, (1.32 ± 1.23) cm3 and (0.59 ± 0.52) cm 3, respectively. There was significant difference in volume of thyroid nodules between before and after microwave ablation ( F = 96.32, P < 0.001). Conclusion:Preoperative CEUS can determine the distribution of the blood supply of thyroid nodules and the course of the feeding vessels, identify the needle-entering position for microwave ablation and the primary ablation area, improve the accuracy of treatment, and reduce the occurrence of complications such as bleeding. Postoperative CEUS can determine whether lesion area is thoroughly ablated, reduce residual lesions and excessive ablation.

Clinical effect of transcatheter arterial chemoembolization combined with microwave ablation versus repeat resection in treatment of recurrent hepatocellular carcinoma / 临床肝胆病杂志

Objective To investigate the clinical effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) (TACE-MWA) versus repeat resection (RR) in the treatment of recurrent hepatocellular carcinoma (RHCC). Methods A total of 178 patients with RHCC who were admitted to The Second People's Hospital of Neijiang from June 2015 to September 2020 were enrolled, and according to the treatment modality, they were divided into RR group with 64 patients and TACE-MWA group with 114 patients. Baseline demographic data, liver function, and tumor conditions before treatment were recorded, and the patients were followed up to October 2021 to compare postoperative overall survival (OS) time and recurrence-free survival (RFS) time between the two groups. Subgroup analysis based on recurrence pattern (recurrence time and tumor size) was performed, and the influencing factors for prognosis were analyzed. The independent samples t -test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data; the Kaplan-Meier method was used for postoperative survival rate, the Log-rank test was used for survival difference analysis, and a multivariate Cox regression analysis was used to investigate independent risk factors for survival. Results The multivariate analysis showed that tumor diameter, alpha-fetoprotein (AFP) level, alanine aminotransferase, albumin, and time to recurrence were independent prognostic factors for OS (all P 2 years), there were significant differences between the two groups in median OS (54.0 months vs 36.0 months, χ 2 =6.171, P =0.013) and median RFS (28.0 months vs 21.0 months, χ 2 = 5.211, P =0.022). For RHCC with a tumor diameter of ≤5 cm, there was a significant difference in median OS between the two groups (33.0 months vs 27.0 months, χ 2 =6.447, P =0.011). Conclusion RR has a similar clinical effect to TACE-MWA in RHCC with early recurrence or a tumor diameter of > 5 cm, but RR should be the first choice for RHCC with late recurrence or a tumor diameter of ≤5 cm.

Application of the three-dimensional visualization ablation planning system in radiofrequency ablation for hepatocellular carcinoma / 临床肝胆病杂志

Objective To investigate the significance of the three-dimensional visualization ablation planning system in radiofrequency ablation for liver cancer. Methods A total of 71 patients who received radiofrequency ablation for hepatocellular carcinoma in Beijing Ditan Hospital, Capital Medical University from July 2017 to December 2020 were enrolled as subjects. The 34 patients in the three-dimensional group used the three-dimensional visualization ablation planning system for radiofrequency protocol planning before surgery and the 37 patients in the two-dimensional group used the two-dimensional image for radiofrequency protocol planning before surgery. The two groups were compared in terms of the indices such as the first-attempt success rate of puncture, complete tumor ablation rate, and tumor-free survival. The Fisher's exact test, the chi-square test of continuous correction, or the Pearson chi-square test was used for comparison of categorical data between two groups; the t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The Kaplan-Meier method was used to plot survival curves, and the Log-rank (Mantel-Cox) test was used for comparison of tumor recurrence and survival; the Cox proportional-hazards regression model analysis was used to investigate the influencing factors for tumor-free survival. Results Compared with the two-dimensional group, the three-dimensional group had a significantly higher first-attempt success rate of puncture (94.12% vs 75.68%, Pearson χ 2 =4.183, P =0.041) and a significantly shorter median time of puncture (5 minutes vs 7 minutes, Z =-2.407, P =0.013). There was no significant difference in complete ablation rate between the three-dimensional group and the two-dimensional group (97.06% vs 91.89%, continuous correction χ 2 =0.183, P =0.669). There were significant differences in the 1-, 2-, and 4-year cumulative tumor-free survival rates between the three-dimensional group and the two-dimensional group (90.8%/78.8%/72.8% vs 61.5%/55.9%/44.7%, χ 2 =5.073, P =0.024). The multivariate Cox regression analysis showed that preoperative planning method, complete or incomplete ablation, and alpha-fetoprotein at 1 month after surgery were independent influencing factors for the tumor-free survival of patients with liver cancer after radiofrequency ablation (all P < 0.05). Conclusion Radiofrequency ablation planning via the three-dimensional visualization ablation planning system can ensure the therapeutic effect of radiofrequency ablation, reduce the recurrence rate of liver cancer, and prolong the tumor-free survival of patients.

Safety and efficacy of irreversible electroporation ablation in treating liver cancer / 中华肝胆外科杂志

Objective:To evaluate the safety and efficacy of irreversible electroporation ablation for liver cancer.Methods:A retrospective study was conducted on 21 patients who underwent irreversible electroporation ablation for liver cancer from September 2018 to August 2019. There were 17 males and 4 females, with a median age of 57.9 (48, 69) years old. Complications were graded according to the Clavien Dindo complication grading system. Tumor response was evaluated by the improved evaluation standard of solid tumor efficacy. Clinical data such as tumor size and operation time were recorded. Tumor recurrence and survival outcomes were followed-up until August 27, 2020.Results:All patients had well-compensated cirrhosis (Child-Pugh A 20 cases, Child-Pugh B 1 case). There was no persistent deterioration of liver function after ablation. The diameter of tumor ranged from 10 to 56 mm, with 7 patients having a tumor diameter over 3 cm. Each of the 21 patients received only once irreversible electroporation ablation and the technical success rate was 100%. The operation time was 2.3 (1.5, 3.5) h. All complications were Clavien Dindo grade Ⅰ, which included pain, fever and brachial plexus strain. Imaging examination 4 weeks after treatment showed a complete remission rate of 85.7% (18/21), a partial remission rate of 9.5% (2/21), a stable disease rate of 0(0/21), and a progressive disease rate of 4.8% (1/21). The objective remission rate was 95.2% (20/21). Overall recurrence rates were 9.5% (2/21) at 3 months and 23.8% (5/21) at 12 months. AFP at 3 and 12 months after treatment were (28.0±7.3) and (29.0±8.1) ng/ml, respectively, which were significantly lower than that before treatment (278.0±41.2) ng/ml ( t3m=-3.57, t12m=-4.12, P<0.05). Conclusion:Irreversible electroporation ablation was safe and effective in treating malignant liver tumors.

Current application status of thermal ablation in the treatment of low-risk papillary thyroid microcarcinoma / 国际外科学杂志

With the gradual popularization of high-resolution ultrasound, the wide application of fine-needle aspiration biopsy technology under ultrasound guidance, and the rapid development of molecular marker detection technology, the detection rate of papillary thyroid microcarcinoma (PTMC) has increased year by year.The main clinical treatment method for PTMC is surgery or active surveillance. In recent years, with the good application of thermal ablation technology in the treatment of liver cancer, benign thyroid nodules and other tumors, many scholars at home and abroad advocate applying this technology in the treatment of PTMC.However, there is still a lack of multicenter, prospective long-term studies with large sample size to confirm the safety and effectiveness.Therefore, it is highly controversial whether thermal ablation should be applied to the initial treatment of PTMC.This paper will comment on this hot issue.

Manejo anestésico para electroporación irreversible en el paciente pediátrico / Anesthetic management for irreversible electroporation in the pediatric patient

Resumen: Introducción: La electroporación irreversible (EIR) es una técnica conocida desde 1972; fue incorporada al ámbito oncológico en el año 2005 como técnica de ablación tumoral basada en pulsos eléctricos cortos de alto voltaje y es utilizada para introducir elementos químicos por difusión, alterar la estructura genética celular, fusionar una célula con otra (reversible) o provocarle la muerte (irreversible). Estas descargas eléctricas conllevan un riesgo asociado de arritmias cardíacas, contracciones musculares severas y convulsiones. Mantener un adecuado plano anestésico, analgesia óptima, relajación neuromuscular profunda y electrocardiograma sincronizado a los pulsos eléctricos son los objetivos principales del manejo anestésico. Objetivo: Describir las implicaciones anestésicas de la EIR en el paciente pediátrico. Material y métodos: Revisión narrativa basada en una búsqueda de artículos relacionados con la EIR en las principales bases de datos, donde la principal fuente de información son los reportes de casos y las revisiones no sistemáticas de la literatura, tanto del área de anestesiología y dolor como de ingeniería, radiología intervencionista vascular y cardiovascular, y cirugía. Resultados: Se encontraron y revisaron un total de 17 referencias bibliográficas. Conclusión: La anestesia para EIR en el paciente pediátrico debe garantizar un adecuado plano anestésico idealmente con intubación endotraqueal, analgesia óptima, relajación profunda y control de arritmias cardíacas con sincronización del electrocardiograma.

Abstract: Introduction: Irreversible electroporation (IRE) is a technique known since 1972 incorporated into the oncological field in 2005 as a tumor ablation technique based on short high-voltage electrical pulses used to introduce chemical elements by diffusion, alter the cellular genetic structure, fuse a cell with other (reversible) or cause death (irreversible). These electric shocks carry an associated risk of cardiac arrhythmias, severe muscle contractions and seizures. Maintain an adequate anesthetic plane, optimal analgesia, deep neuromuscular relaxation and an electrocardiogram synchronized to the electrical pulses are the main objectives of anesthetic management. Objective: Describe the anesthetic implications of IRE in the pediatric patient. Material and methods: Narrative review based on a search for articles related to IRE in the most important databases, where the main source of information is case reports and non-systematic reviews of the literature, both in the area of anesthesiology and pain as well as engineering, vascular and cardiovascular interventional radiology, and surgery. Results: A total of 17 bibliographic references were found and reviewed. Conclusion: The anesthesia for IRE in the pediatric patient should guarantee an adequate anesthetic plane ideally with endotracheal intubation, optimal analgesia, deep relaxation and control of cardiac arrhythmias with electrocardiogram synchronization.

Percutaneous injection of ethanol for thyroid nodule treatment: a comparative study

ABSTRACT Objective: Percutaneous ethanol injection (PEI) is an alternative to surgery for the treatment of thyroid nodules (TNs). However, size reductions of treated (TTNs) and untreated TN (UTNs) have not been compared. Volumetric reductions in TTNs with PEI were evaluated by comparing TTNs and UTNs in the same patient, and independent variables predicting good post-PEI outcomes were analyzed. Materials and methods: Overall, 282 patients with multinodular goiters were selected. Two nodules located in different lobes were compared for common disease behaviors. Overall, 150 nodules were selected from 75 patients (6 M: 69 F) with a mean age of 50.1 ± 17.4 years. This prospective nonrandomized intervention study prioritized treating TNs of greater volume or single hyperfunctioning TNs. A single observer experienced in PEI and an ultrasound specialist performed the interventions. Results and discussion: TTNs (mean volume: 14.8 ± 16.2 mL) were reduced by 72.6 ± 27.3% of their initial volume, while UTNs increased by a mean of 365.7 ± 1.403.8% (p < 0.00001). The patients underwent a mean of 4.0 ± 3.1 outpatient PEI sessions without relevant complications. Logistic regression analysis showed that the magnitude of the PEI induced reduction was associated with the number of treatment sessions (p = 0.03, CI [1.1-38.2]) and not with ultrasonographic characteristics of the nodules. Each PEI session increased the rate of TN reduction by a factor of 6.7. Conclusions: PEI is a well-tolerated outpatient procedure that effectively reduces the volume of TNs and is noticeably superior to conservative treatment for all ultrasonographic classifications.

A comparison between microwave ablation and surgical resection for small hepatocellular carcinoma / 中华普通外科杂志

Objective:To compare the clinical effects of microwave ablation (MWA) and surgical resection in the treatment of small hepatocellular carcinoma(SHCC).Methods:Sixty five SHCC patients with intact clinical data, treated in the Center of Hepatobiliary Surgery, Peking University People's Hospital between Feb 2005 and Aug 2012, were enrolled in this study. Among them, 30 patients were treated by MWA, and the other 35 by hepatectomy. Follow-up was conducted from Mar 2013 to Feb 2021. The differences in long-term survival, intraoperative blood loss, operative time, postoperative complications, performance status (PS), and postoperative hospital stay were compared between the two groups.Results:The survival probability at 1, 3, 5 and 10 years was 93.2%, 82.5%, 55.6% and 41.2%, respectively, in the MWA group, and 97.1%, 82.6%, 67.2% and 48.3%, in the resection group ( P=0.347). The MWA group had less perioperative complications, less blood loss, shorter operation time, better PS score and better hospital stay than the surgical resection group (all P<0.001).There was no statistically significant difference in the survival rate between BCLC stage 0~A1 and A2~A4 patients( P=0.773, 0.536). Conclusions:Microwave ablation in the treatment of small hepatocellular carcinoma can achieve similar results as hepatectomy with less traumatic,better postoperative PS score and shorter postoperative hospital stay.

Progress of day surgery techniques for varicose great saphenous vein / 国际外科学杂志

Varicose great saphenous vein is a common disease of vascular surgery. The treatment needs of a large number of patients and the progress of surgical techniques provide the necessity and feasibility for the active implementation of day surgery. Endovenous thermal closure techniques (laser closure and radiofrequency ablation) and non-thermal, non-tumescent techniques have the advantages of less trauma, faster recovery and fewer complications, and the effective rate and recurrence rate are not inferior to ligation and stripping. Sclerotherapy and phlebectomy are important auxiliary techniques.This paper analyzes and compares the technical characteristics and effectiveness of ambulatory surgeries for varicose great saphenous vein.

Research advances in diaphragmatic hernia after thermal ablation for primary liver cancer / 临床肝胆病杂志

Thermal ablation, including radiofrequency ablation and microwave ablation, is a frequently used method for local treatment of primary liver cancer with a marked clinical effect, and it has been widely used in clinical practice in recent years. Diaphragmatic hernia is a rare complication of thermal ablation, but its incidence rate tends to gradually increase in recent years. This article reviews the cases of diaphragmatic hernia after thermal ablation for primary liver cancer in China and globally and elaborates on possible risk factors, diagnosis and treatment, and prevention strategies, so as to improve the understanding of diaphragmatic hernia after thermal ablation for primary liver cancer among clinicians and achieve the goal of preoperative prevention, rapid diagnosis and intervention, and reduced mortality rate.

Current developmental status of non-surgical treatment of hepatocellular carcinoma / 临床肝胆病杂志

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with high mortality in clinical practice. With the development of imaging and interventional techniques, transcatheter arterial chemoembolization and local ablation are more and more widely used for treatment and can even achieve a similar effect as surgery in the treatment of some types of early-stage HCC. In addition, precision medicine and biomedicine have also developed vigorously; radiochemotherapy is more accurate and effective in the treatment of HCC, and molecular targeted therapy, immunotherapy, and gene therapy have become the directions for breakthrough in the future. This article reviews the latest advances in the non-surgical treatment of HCC.

Current status and advances in ultrasound-guided thermal ablation for hepatocellular carcinoma / 临床肝胆病杂志

Hepatocellular carcinoma (HCC) is a common malignant tumor in clinical practice, and image-guided thermal ablation is a radical treatment method for early-stage HCC and a method for palliative tumor reduction and combination with systematic therapy for advanced HCC. With the advantages of real-time imaging, accurate guiding, easy operation, portability, low cost, no radiation damage, and high efficiency, ultrasound plays an important role in preoperative planning, intraoperative guiding, postoperative evaluation, and long-term follow-up in thermal ablation for HCC. With the advances in ultrasound and imaging fusion technology and the development of functional imaging technology represented by photoacoustic imaging, ultrasound-guided thermal ablation is at the forefront of precision treatment of HCC, achieving long-lasting development and developing into a more minimally invasive, accurate, safe, and effective diagnostic and therapeutic mode.