Initial Results of Safety and Efficacy of Artificial Ascites - Assisted Thermal Ablation of Hepatocellular Carcinoma at High Risk Location

Abstract

Introduction: Primary hepatocellular carcinoma (HCC) is a common malignancy worldwide with high mortality. Thermal ablation is a potentially curative therapy, but ultrasound-guided ablation of tumors in
high-risk locations is often limited by poor visualization and risk of thermal injury to adjacent organs. Artificial ascites offers a simple and effective solution to improve safety. This study evaluated the efficacy, safety, local recurrence, and clinical outcomes of artificial ascites-assisted thermal ablation for high-risk HCC.
Methods: We conducted a retrospective case series of patients diagnosed with HCC in high-risk sites who underwent thermal ablation with artificial ascites assistance.
Results: A total of 12 patients with hepatocellular carcinoma underwent thermal ablation. The mean age was 66.5 ± 9.07 years (range, 49–79), with a male-to-female ratio of 2:1. Of these, seven patients were
treated with microwave ablation and five with radiofrequency ablation. The mean distance between the tumor and critical adjacent organs was 4.25 ± 2.73 mm (range, 1–8 mm). Artificial ascites was successfully created via a 6F angiosheath in all cases (technical success rate: 100%), with a mean infused volume of 1054.2 ± 423.97 ml (range, 500–2000 ml). No major complications occurred following the procedure.
Conclusion: Artificial ascites-assisted thermal ablation is a safe and effective approach for treating primary HCC in high-risk locations, reducing the risk of collateral injury and improving treatment feasibility.