3. Radiofrequency ablation:
A new method that is way less invasive than resection and transplant. It is a thermal ablation technique that uses a probe that passes to the middle of the tumor percutaneously under ultrasound or CT guidance or through laparoscopy and passes an electric current of 500 KHZ and this heat leads to a zone of necrosis within the tumor. It is a simple procedure that can be done in less than half an hour with fewer complications and better end results, but it has limitations in that the maximum zone of necrosis created by the ablation doesn’t exceed 7 cm, which makes it only suitable for lesions that are 5 cm or less and preferably deep tumors within the liver parenchyma away from the helium of the liver that contains important structures like the hepatic artery, hepatic vein, portal vein, and porta hepatis, which could be accidentally injured if it is close to the helium. As a result, the smaller the lesion the better the outcome and it can be repeated more than once to achieve the best results.
Another ablation technique is cryoablation that does the opposite by using cold temperatures – 190 c to cause tumor necrosis without affecting the surrounding structures.
An old method that is similar to ablation but cheaper is percutaneous ethanol or acetic acid injections which requires that the mass to be less than 3 cm and mainly less than 3 in number, but it has a high recurrence rate and doesn’t provide good results as ablation nowadays.
