Results of application of chemical destruction in complex treatment of focal hepatic pathology

Keywords: chemical ablation; hepatic focal pathology; 10% solution of calcium chloride.

Abstract

Objective. To estimate the immediate results of application of chemical destruction with 10% solution of calcium chloride in complex of treatment in the patients, suffering focal hepatic pathology.

Маterials and methods. In 2012 - 2019 yrs, using chemical destruction, the impact was delivered towards 104 tumoral foci (range from 1 tо 4) in the patients, suffering hepatocellular carcinoma (23.7%), colorectal cancer metastases (55.3%) and in noncolorectal cancer (21.1%). The foci diameter have constituted at average (2.60 ± 1.24) сm (in 1.0 - 4.0 сm range). Chemical ablation was performed, using injections of 10% solution of calcium chloride. Side-effects and answer of tumoral foci were estimated.

Results. The specific postoperative complications rate (formation of abscesses in zone of destruction, development of hematomas and biliomas) have constituted 10.5%. There were observed a complete answer in the foci 1.0 - 1.5 сm in diameter, while the disease progress - concerning the foci 3,8 - 4,2 сm in diameter. Local recurrence have occurred in 15.8% patients. The answer degree trustworthily depended upon the tumoral foci density (r=0.529, р < 0.001). Including, complete answering was observed in 76.9% hypodense, 23.1% іsodense foci, and partial - concerning 37.8% hypodense, 29.7% іsodense and 32.4% of the foci of mixed structure. Stabilization of the disease was diagnosed, concerning 15.0% іso- and hypodense, 40.0% hyperdense and 45.0% with the foci of mixed structure, while a progress - concerning 85.7% hyperdense and 14.3%of the foci of mixed density.

Conclusion. Іntratumoral injection of 10% solution of calcium chloride in the treatment of focal hepatic pathology is not accompanied by severe specific complications and mortality, the patients are survive the procedure satisfactory, which may be applied as a local tumoral control of tumoral foci up to 3.0 сm in diameter.

Author Biographies

О. I. Dronov, Bogomolets National Medical University, Kyiv

Dronov O.I. - MD, Doctor of Sci (Med), Professor
Head Of Department Of General Surgery #1
Bogomolets National Medical University
13 Shevchenko avenue, 01004, Kyiv, Ukraine
tel. +38044 234 4062
kafedra1nmu@gmail.com
https://orcid.org/0000-0003-4033-3195

I.O. Kovalska, Bogomolets National Medical University, Kyiv

Kovalska I.O. - MD, Doctor of Sci (Med), Professor
Department Of General Surgery #1
Bogomolets National Medical University
13 Shevchenko avenue, 01004, Kyiv, Ukraine
tel. +38044 234 4062
kafedra1nmu@gmail.com
https://orcid.org/0000-0002-6264-2928

E. S. Коzachuk, Bogomolets National Medical University, Kyiv

Kozachuk Ye.S. - MD, Assistant Professor
Department Of General Surgery #1
Bogomolets National Medical University
13 Shevchenko avenue, 01004, Kyiv, Ukraine
tel. +38044 234 4062
kafedra1nmu@gmail.com
https://orcid.org/0000-0002-2453-2496

P. P. Bakunets, Кyiv’s Municipal Centre of Surgery of the Liver, Biliary Ducts and Pancreatic Gland named after V. S. Zemskov

Bakunets P.P. - MD, PhD (Med)
Kyiv City Center Of Liver, Pancreas And Bile Duct Surgery
13 Shevchenko avenue, 01004, Kyiv, Ukraine
tel. +38044 234 4062
bakunetspetro@gmail.com
https://orcid.org/0000-0003-2792-0993

References

Toso C, Mentha G, Kneteman NM, Majno P. The Place of Downstaging for Hepatocellular Carcinoma. J Hepatol. 2010;52(6):930-6. doi: 10.1016/j.jhep.2009.12.032.

Singla S, Hochwald SN., Kuvshinoff B. Evolving Ablative Therapies for Hepatic Malignancy. Biomed Res Int, 2014;2014:16 doi:10.1155/2014/230174.

Sviridova TI, Bruslik SV, Vetshev PS Neinvazivnaja ultrazvukovaja abljacija opuholej pecheni. Annaly Hirurgicheskoj Gepatologii. 2014;19(1):110-9 [In Russian].

Gorbunovoj VA, editor. Konservativnoe lechenie pervichnogo i metastaticheskogo raka pecheni. Moskow: Medicinskoe informacionnoe agenstvo; 2013. 288 p. [In Russian].

Pompili M, De Matthaeis N, Saviano A, De Sio I, Francica G, Brunello F. Single hepatocellular carcinoma smaller than 2 cm: are ethanol injection and radiofrequency ablation equally effective? Anticancer Res. 2015;35(1):325-32 PMID: 25550567.

Riemsma RP, Bala MM, Wolff R, Kleijnen J. Percutaneous Ethanol Injection for Liver Metastases. Cochrane Database Syst Rev. 2013;(5):CD008717. doi: 10.1002/14651858.CD008717.pub2.

Tashhiev RK. Pervichnij i metastaticheskij rak pecheni. Kyiv:Izdatelstvo «Zaslavskij A. Ju.»; 2008. 245 p.[In Russian].

Olejnik VA, Matjashhuk SI, Najda JuN, Shelkovoj EA, Markov VV, Motornyj EO. Skleroterapija jetanolom dobrokachestvennyh novoobrazovanij shhitovidnoj zhelezy Endokrinologіja. 2012;17(4):44-55. [In Russian].

Yu H, Burke ChT. Comparison of Percutaneous Ablation Technologies in the Treatment of Malignant Liver Tumors. Semin Intervent Radiol. 2014;31:129-37. doi: 10.1055/s-0034-1373788.

Published
2019-05-05
How to Cite
DronovО. I., Kovalska, I., КоzachukE. S., & Bakunets, P. P. (2019). Results of application of chemical destruction in complex treatment of focal hepatic pathology. Klinicheskaia Khirurgiia, 86(5), 12-16. https://doi.org/10.26779/2522-1396.2019.05.12
Section
General Problems of Surgery