Artificial ascites assisted microwave ablation for liver cancer adjacent to the diaphragm and perioperative nursing care

Abstract

Abstract Background To investigate the feasibility and effectiveness of artificial ascites assisted microwave ablation (MWA) in the treatment of liver cancer near the deep diaphragm and the importance of perioperative nursing. Methods A retrospective analysis was performed on patients who received MWA assisted by artificial ascites for liver cancer adjacent to the deep diaphragm from January 2016 to December 2022. Normal saline was used as artificial ascites to protect the deep diaphragm during MWA. The success rate of the procedure, the incidence of major complications, the technical efficacy of ablation, and the local tumor progression were recorded. Results A total of 62 lesions in 54 patients were enrolled, including 44 males and 10 females, with an average age of 55.64 ± 10.33 years. The ultrasound image quality scores of liver cancer before and after ascites were 3.57 ± 0.79 and 4.89 ± 0.33, respectively. The difference between the two groups was statistically significant (t = 16.324, P < 0.05). There was no injury to the diaphragm, no burn to the skin at the puncture site, and no abdominal hemorrhage. 1 patient developed a right pleural effusion, which was not drained. The complete ablation rate was 94.4% (51/54) at 1 month after ablation. Three patients had recurrence and were treated with MWA again. The patients in this study were followed up for 12 to 45 months, with a median follow-up time of 21 months. The local tumor progression rate was 5.6% (3/54). Conclusion MWA assisted by artificial ascites is a safe and effective treatment for liver cancer near the deep diaphragm. Systematic nursing measures are of great significance for the rapid recovery of patients and the success rate of surgery.