Radiofrequency ablation for hepatocellular carcinoma and liver metastases: experience in Hospital La Paz.

INTRODUCTION: Radiofrequency ablation for patients presenting with non-resectable primary or metastatic liver tumours seems to be a valid therapeutic alternative. In the present study, we show a descriptive list of indications, results and complications of Radiofrequency Ablation Technique for treating non-resectable solid hepatic tumours. MATERIALS AND METHODS: Twenty two patients were included in this study; eleven of them (50%) sustained liver metastases from colorectal adenocarcinoma, ten patients (45.5%) had hepatocellular carcinoma and 1 patient had insulinoma. RESULTS: Local recurrence rate of hepatocellular carcinoma was 22.7% and 27.3% for colorectal carcinoma, after a respective median follow-up of 21 and 14 months. Complications rate was 6.9% and technique-associated mortality rate was 0%. CONCLUSIONS: Radiofrequency ablation is an easy to make, safe and useful technique for the treatment of primary and metastatic liver tumours.

[Secondary prophylaxis with elastic band ligation in esophageal-gastric varices]. / Profilaxis secundaria mediante ligadura con bandas elásticas en varices esofagogástricas.

The aim of the present study was to determine the usefulness of elastic band ligation in the prevention of hemorrhage recurrence due to esophageal-gastric varices. Sixty-five patients who survived an episode of variceal hemorrhage were included in the study. Twenty-nine patients (45%) were Child-Pugh class A, 25 (38%) were class B, and 11 (17%) were class C. The cause of cirrhosis was hepatitis C virus and alcohol in 45% and 31% of the patients, respectively. The first ligation session was performed between the third and fifth day after the hemorrhagic episode and subsequent sessions were carried out at intervals of 3-4 weeks. The ligation sessions were performed with antibiotic prophylaxis. A mean of 2.7 bands were placed per session (range 1-5), and the mean number of sessions required per patient to achieve variceal eradication was 2.5 (range 1-6). The rate of bleeding recurrence was 24.6% (16 episodes). In conclusion, endoscopic elastic band ligation is a useful technique for the eradication of esophageal varices and for the prevention of bleeding recurrence.

Sarcoma de Kaposi gástrico: antes y después del tratamiento antirretroviral / Gastric Kaposi’s sarcoma: before and after antiretroviral therapy

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Profilaxis secundaria mediante ligadura con bandas elásticas en varices esofagogástricas / Secondary prophylaxis with elastic band ligation in esophageal-gastric varices

El objetivo del presente estudio fue determinar la utilidad de la ligadura con bandas elásticas en la prevención de la recidiva hemorrágica por varices esofagogástricas. Se incluyó a 65 pacientes que sobrevivieron a un episodio hemorrágico por varices. Veintinueve (45%) eran Child A, 25 (38%) B y 11 (17%) C; el virus C y el alcohol fueron la etiología de la cirrosis en el 45 y el 31% de los casos, respectivamente. La primera sesión de ligadura se realizó entre el tercer y el quinto día después del episodio hemorrágico, y las sesiones posteriores a intervalos de 3-4 semanas. Las sesiones de ligadura se realizaron con profilaxis antibiótica. Se aplicó una media de 2,7 bandas por sesión (rango, 1-5), y la media de sesiones por paciente hasta erradicar las varices fue de 2,5 (rango, 1-6). La tasa de recidiva hemorrágica fue del 24,6% (16 episodios). En conclusión, la ligadura endoscópica con bandas elásticas es una técnica útil para la erradicación de varices esofágicas y en la prevención de recidiva hemorrágica

The aim of the present study was to determine the usefulness of elastic band ligation in the prevention of hemorrhage recurrence due to esophageal-gastric varices. Sixty-five patients who survived an episode of variceal hemorrhage were included in the study. Twenty-nine patients (45%) were Child­Pugh class A, 25 (38%) were class B, and 11 (17%) were class C. The cause of cirrhosis was hepatitis C virus and alcohol in 45% and 31% of the patients, respectively. The first ligation session was performed between the third and fifth day after the hemorrhagic episode and subsequent sessions were carried out at intervals of 3-4 weeks. The ligation sessions were performed with antibiotic prophylaxis. A mean of 2.7 bands were placed per session (range 1-5), and the mean number of sessions required per patient to achieve variceal eradication was 2.5 (range 1-6). The rate of bleeding recurrence was 24.6% (16 episodes). In conclusion, endoscopic elastic band ligation is a useful technique for the eradication of esophageal varices and for the prevention of bleeding recurrence