Optimized hydrodissection technique assisted microwave ablation for subpleural pulmonary tumors
Objective To evaluate the efficacy and safety of the Optimized Hydrodissection Technique(OHT)as an assis-tive technology in relieving pain during microwave ablation.Method A retrospective analysis was conducted on the medical records of 327 patients with subpleural pulmonary tumors diagnosed by pathological biopsy who underwent OHT-assisted Computed Tomography-guided percutaneous microwave ablation in Shandong Province Qianfoshan Hospital from January 1,2020,to December 31,2021.The effectiveness of OHT was evaluated by using the immediate Visual Analogue Scale(VAS)post-OHT,with patients categorized into the OHT effective group(VAS≤6 points,284 cases)and the OHT ineffective group(VAS≥7 points,43 cases).Descriptive statistical analysis was used to analyze the epidemiological and treatment-related characteristics of the two groups.The Mann-Whitney U test was employed to assess the differences in VAS scores between the two groups at various time points,including before micro wave ablation,intraoperatively(both before and immediately after OHT),and postprocedural at 6,12,and 24 hours.For evaluating the influencing factors that contributed to the differential pain relief efficacy of OHT,a Chi-square test or the Fisher exact test was utilized,as appro-priate.Local control rates and major complications were also recorded.Results Among the 327 patients treated with OHT-assisted microwave ablation,the effective rate of OHT was 86.85％(284/327).Significant differences in VAS scores were observed between the two groups immediately post-OHT,and at 6 and 12 hours post-OHT(U values were 49.110,8.185 and 6.710,respectively;all P＜0.001).Factors affecting the pain relief effect of OHT included the thick-ness of the isolation layer(P＜0.001)and the tumor location(cervical pleura:P＜0.001;diaphragmatic pleura:P=0.001).The local control rates at 1,3,6,and 12 months postprocedural were 98.78％(323/327),98.78％(323/327),95.11％(311/327),and 92.35％(302/327),respectively.Notable postprocedural complications included pneumothorax in 67 cases(20.49％),pleural effusion 59 cases(18.04％),hemoptysis 45 cases(13.76％),nausea and vomiting 41 cases(12.54％),constipation 35 cases(10.70％),hemothorax 5 cases(1.53％),and bronchopleural fistula 2 cases(0.61％).Conclusions OHT is a safe and effective assistive technology for relieving pain in patients with subpleural pulmonary tumors during and after microwave ablation.The thickness of the isolation layer and tumor location are influencing factors of the pain relief effect of OHT.
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