Efficacy and security of high-intensity focused ultrasound in the treatment of child hepatoblastoma with the aid of artificial hydrothorax

Abstract:

Objective：To evaluate the availability and security of high-intensity focused ultrasound（HIFU） in the treatment of child hepatoblastoma with the aid of artificial hydrothorax. Methods：Fourteen children（18 lesions）with hepatoblastoma received general anesthesia using trachea cannula. 200-300 ml saline was injected into the right thoracic cavity to turn artificial pleural fluid. Mean invasive arterial pressure（IABP），heart rate（HR），peak airway pressure（Ppeak），compliance of lung（Cmpl），end-tidal carbon dioxide partial press（PETCO2） and oxygen saturation（SpO2） were observed and recorded separately at 5 min after intubation（T0），10 min after establishment of artificial hydrothorax（T1），30 min after HIFU treatment（T2），1 h after HIFU treatment（T3），2 h after HIFU treatment（T4） and at the end of HIFU treatment（T5）. Blood gad analysis was made at T0-T5 and 24 h after HIFU treatment（T6）. On the 1st d and the 7th d after HIFU treatment，chest X-ray was made to evaluate the hydrothorax and lungs. Before and after HIFU treatment MRI was made to evaluate the availability. Results：During HIFU treatment，all children were steady in various indicators of haemo－dynamics. Ppeak was increased significantly after the establishment of artificial hydrothorax compared with that of T0（P<0.05）and was maintained at the high level；Cmpl was decreased significantly after the establishment of artificial hydrothorax compared with that of T0（P<0.05）. PETCO2 was increased significantly after T2（P<0.05）；PO2 and PCO2 were both increased significantly after T1（P<0.05）. But pH values were not change significantly（P>0.05） and the fluctuations of the respiratory parameters above were all within the safety margin. X-ray showed that artificial hydrothorax was absorbed within 7 d after HIFU treatment. Severe complications like pneumothorax or haemothorax were not ob－served. Postoperative imaging studies（MRI or enhanced CT） prompted all children with lesions reach a predetermined radio frequen－cy ablation effect. Conclusion：HIFU is effective and safe in the treatment of child hepatoblastoma with the aid of artificial hydrothorax.