Application of breathing needle control combined with the maximum area projection of the lesion in CT-guided percutaneous transpulmonary puncture for microwave ablation of subphrenic hepatic tumors

Objective: To investigate the application value of 'breathing needle control' together with maximum area projection of the lesion' technique in performing CT-guided percutaneous transpulmonary puncture microwave ablation (MWA) for subphrenic hepatic tumors. Methods: The clinical data of 53 patients, who received CT-guided percutaneous transpulmonary puncture MWA of subphrenic hepatic tumors, were retrospectively analyzed. The patients were divided into the study group (n = 29) and the control group (n = 24). With the help of 'breathing needle control' technique to eliminate the effect of respiratory movement on puncturing and with the use of 'maximum area projection of the lesion' technique to accurately plan the needle path and to predict the ablation extent, CT-guided percutaneous transpulmonary puncture MWA was carried out in the patients of the study group, while routine CT-guided percutaneous transpulmonary puncture MWA was performed in the patients of the control group. The number of puncturing, the complications and the short-term curative effect were compared between the two groups. Results: The number of puncturing in the study group was (1.1 ± 0.3) times, which was less than (3.1 ± 0.9) times of that in the control group, the difference was statistically significant (P < 0.05). The postoperative complications in the two groups included pneumothorax, hepatic subcapsular hemorrhage, diaphragmatic injury (mainly manifested as intraoperative and/or postoperative back and shoulder pain). The incidences of pneumothorax, hepatic subcapsular hemorrhage and diaphragm injury in the study group were 6.9% (2/29), 10.3% (3/29) and 0% (0/29) respectively, which were 54.2% (13/24), 37.5% (9/24) and 33.3% (8/24) respectively in the control group, the differences between the two groups were statistically significant (P < 0.05). The complete ablation rate of hepatic tumors in the study group was 93.1% (27/29), which was 70.8% (17/24) in the control group, the difference between the two groups was statistically significant (P < 0.05). Conclusion: In performing CT-guided percutaneous and transpulmonary puncture MWA for subphrenic hepatic tumors, the combination use of 'breathing needle control' and 'maximum area projection of the lesion' technique can improve the complete ablation rate and reduce complications. Therefore, this technique is worthy of promotion. (authors)