What are the Possible Risks of Radiofrequency Ablation?
Procedure-related complications tend to be unusual after RFA and tend to be dependent on the part of the body being treated.
The risks of treating patients with liver disease include bleeding around the liver (subcapsular hematoma), fluid collection around the lung (pleural effusion), fluid collection around the liver (ascites), obstruction of the bile ducts within the liver, inflammation of the gallbladder, shoulder pain due to inflammation of the diaphragm, and infection with possible abscess formation. Serum liver function tests tend to be elevated for several days following the treatment of liver lesions but for most patients, these lab values return to baseline within a week.
The risks of treating patients with kidney disease include bleeding around the kidney, obstruction to urine flow from the treated kidney, and reduced function or the treated kidney.
The risks of treating patients with lung disease include bleeding within and around the lung and collapse of lung (pneumothorax) due to air leaking around the needle and entering the space surrounding the lung.
While many of these complications can be observed without additional treatment, some may require additional procedures for treatment.
How do we follow Patients after Radiofrequency Ablation?
After RFA, all patients require follow-up imaging on a regular basis to determine if the treated lesions have grown or if new lesions have developed.
We typically perform a CT scan in 1 month, which then serves as our new “baseline” for future imaging. CT scans are then performed at 3 month intervals for 1 year. If the disease is stable at that point, this changes to performing CT scans at 6 month intervals.
Initially, tumors after RFA may appear larger than they did before the procedure. That is because the tumor and the liver tissue immediately surrounding the tumor are addressed with RFA.
In some patients, the post-treatment inflammatory changes surrounding the treated tumor may be difficult, if not impossible, to differentiate from recurrent or incompletely treated tumor. Time is often the only way to make this differentiation.
Concern arises when continued growth is seen within the area treated with RFA and if that is seen, additional treatment will need to be considered. Typically, areas treated completely result in necrotic changes that shrinks over the course of several months.