What is Radiofrequency Ablation of Liver Tumors

Radiofrequency ablation is a procedure to destroy specific cells using high-energy radio waves. During radiofrequency ablation of liver tumors, a needle-like probe is placed close to the liver tumor.

The probe uses radio waves to produce heat that kills cancer cells. Months later, the dead tumor cells turn into harmless scar tissue. This procedure is usually used:

• For tumors:
  • That are small, usually less than 1½ in (3.8 cm).
  • That are in high-risk locations.
  • That have not shrunk with chemotherapy.
  • That have come back after surgical removal.
• In people whose medical condition makes surgery too dangerous.
• In people who have certain types of liver cancer and are on a waiting list for a liver transplant.

Tell a health care provider about:

• All allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Flu-like symptoms, including fever and achiness.
• Pain.
• Damage to other structures or organs, such as a lung or the intestines.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• You may have blood tests done. These tests can help show how well your kidneys and liver are working. They can also show how well your blood clots.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
  • Hair may be removed from the surgical area.
• You will lie on an exam table. You will be connected to monitors that keep track of your heart rate, blood pressure, and breathing throughout the procedure.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area where the probe will pass through the skin (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your health care provider will perform radiofrequency ablation. This will be done:
  • Through an incision. This type of ablation is called surgical radiofrequency ablation.
  • Through a tiny surgical incision, using a camera-like device to guide the probe to the liver tumor. This type of ablation is called laparoscopic radiofrequency ablation.
  • Using needle-sized electrodes that are passed through the skin directly into the area of the liver that is being treated. This type of ablation is called percutaneous radiofrequency ablation.
• Ultrasound or CT scans will be done to make sure the tip of the probe is in the right location.
• Once the probe has been positioned next to the tumor, radio waves will produce heat that kills the tumor cells. Depending on the size of the tumor, the probe may need to be repositioned several times.
• Once the tumor has been destroyed, the probe will be removed.
• A bandage (dressing) will be placed over the area where the probe was inserted.
• If an incision was made, it will be closed with stitches (sutures), skin glue, or adhesive strips. A dressing will be placed over the area.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• If you were given a sedative or a general anesthetic, you will be sleepy for the first few hours after the procedure.
• You may have some pain or nausea. This can usually be controlled with medicines.
• Do not drive for 24 hours if you were given a sedative.
• Depending on the type of procedure you had, you may need to stay in the hospital for up to a day or more. Ask your health care provider how long you will need to recover in the hospital.

Summary

• Radiofrequency ablation is a procedure to destroy specific cells using high-energy radio waves.
• During radiofrequency ablation of liver tumors, a needle-like probe is placed close to the liver tumor. The probe uses radio waves to produce heat that kills cancer cells.
• Plan to have someone take you home from the hospital or clinic.
• After the procedure, you may have some pain or nausea. This can usually be controlled with medicines.

Radiofrequency Ablation of Liver Tumors, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedure, it is common to have pain and discomfort in the upper abdomen. You will be given pain medicines to control this.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, use it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Activity

• Rest as often as needing during the first few days of recovery.
• Do not lift anything that is heavier than 10 lbs (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.
• Do not drive for 24 hours after the procedure if you were given a medicine to help you relax (sedative).

General instructions

• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Follow any special diet instructions as directed by your health care provider.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You cannot pass gas.
• You are unable to have a bowel movement within 2 days.
• You have a skin rash.

Get help right away if:

• You have a fever.
• You have severe or lasting pain in your abdomen, shoulder, or back.
• You have trouble swallowing or breathing.
• You have severe weakness or dizziness.
• You have chest pain or shortness of breath.

Summary

• After your procedure, it is common to have pain and discomfort in the upper abdomen. You will be given pain medicines to control this.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Do not drive or use heavy machinery while taking prescription pain medicine.