Percutaneous extrapulmonary radiofrequency ablation for tumors in the hepatic dome

Background/Aims: This study aims to assess the feasibility of one lung ventilation and computed tomography-guided extrapulmonary percutaneous radiofrequency ablation for tumors in the hepatic dome. Methodology: Eleven patients (1.0 men, 1 women; age range, 34-84 years) with 12 tumors in the hepatic dome were enrolled in the study after institutional review board approval and informed consent had been obtained. A 35F or 37F left-sided double-lumen endotracheal tube was intubated after general anesthesia was induced. The right lung is permitted to collapse, with selective left lungs ventilation. With CT monitoring, the RF electrode was inserted through the empty pleural space to the targeted tumor and radiofrequency ablation procedures were performed. Results: The median operative time was 122 minutes. The median one lung ventilation time was 134 minutes. The procedures of one lung ventilation and percutaneous radiofrequency ablation were successfully performed. There was no bronchial intubation, one lung ventilation and percutaneous radiofrequency ablation related complications, excluding minor pleural effusions recovering without thoracentesis in 2 patients. Complete tumor necrosis was achieved in 10 patients (90.9%). Conclusions: One lung ventilation and computed tomography guided percutaneous extrapulmonary radiofrequency ablation for tumors in the hepatic dome appears to be useful and safe.