Clinical, Morphological Justification and First Experience in the Use of Radiofrequency as Well as Microwave Ablation Treatment Methods of Liver Echinococcosis

Alexey Shabunin; Alexey Karpov; Vladimir Bedin; Mikhail Tavobilov; Grigory Checenin; Sergey Lebedev; Natalya Ivanova; Anatoliy Malishev; Mark Aladin; Kirill Abramov

doi:10.18502/ijpa.v18i1.12380

Clinical, Morphological Justification and First Experience in the Use of Radiofrequency as Well as Microwave Ablation Treatment Methods of Liver Echinococcosis

Iran J Parasitol. 2023 Jan-Mar;18(1):56-65. doi: 10.18502/ijpa.v18i1.12380.

Authors

Alexey Shabunin^{1

2}, Alexey Karpov¹, Vladimir Bedin^{1

2}, Mikhail Tavobilov^{1

2}, Grigory Checenin^{1

2}, Sergey Lebedev^{1

2}, Natalya Ivanova¹, Anatoliy Malishev¹, Mark Aladin², Kirill Abramov¹

Affiliations

¹ Botkin Hospital, Moscow Healthcare Department, Moscow, Russian Federation.
² Department of Surgery, Russian Medical Academy, Continuing Professional Education, Ministry of Health, Moscow, Russian Federation.

Abstract

Background: The current study considers a new direction of surgical treatment of liver echinococcosis - the use of minimally invasive treatment methods of parasitic cysts.

Methods: After clinical and morphological substantiation of the very possibility of carrying out such procedures, 9 microwave ablations (MWA) and 3 radiofrequency ablations (RFA) of cysts were performed in patients with liver echinococcosis from 2017 to 2021 in the surgical clinic of Botkin Hospital, Moscow, Russia. A comparative analysis of treatment results of patients with echinococcal liver cysts (12 patients who underwent "percutaneous puncture, aspiration, injection and reaspiration" (PAIR) procedure and 12 patients - MWA and RFA) was carried out.

Results: The number of complications according to Clavien-Dindo classification was as follows: 8 after PAIR procedure, 3 after RFA and 3 after MWA. The median hospital length of stay (LOS) after PAIR procedure was 6.46 days versus 4.7 and 4 in the groups of patients who underwent RF and MW ablation, respectively. The frequency of relapses within the first year after PAIR procedure was 25%. The patients who underwent ablation procedures had no relapses of liver echinococcosis during observation.

Conclusion: The presented clinical and morphological substantiation and the experience of using various types of ablation techniques on echinococcal cysts, as well as a comparative analysis with a commonly used PAIR treatment method, demonstrated the safety of RFA and MWA for the patient and efficacy in relation to the hydatid process.

Keywords: Aspiration; Hydatid cyst; Parasitology; Percutaneous puncture.