ペースメーカー植込み患者の原発性肝細胞癌に対しバイポーラ電極針を用いたラジオ波焼灼療法を施行した2例  [in Japanese] Two patients with pacemakers who safely underwent radiofrequency ablation with bipolar electrodes to treat primary hepatocellular carcinoma  [in Japanese]

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Author(s)

    • 伊集院 翔 Ijuin Sho
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学|鹿児島逓信病院肝臓内科 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences|Department of Hepatology, Kagoshima Teishin Hospital
    • 馬渡 誠一 [他] Mawatari Seiichi
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 森内 昭博 Moriuchi Akihiro
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 堀 剛 Hori Takeshi
    • 鹿児島市立病院消化器科 Department of Gastroenterology, Kagoshima City Hospital
    • 井戸 章雄 Ido Akio
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 玉井 努 Tamai Tsutomu
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 宇都 浩文 Uto Hirofumi
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 大西 容雅 Onishi Hiroka
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 坂江 遥 Sakae Haruka
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 室町 香織 Muromachi Kaori
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 大重 彰彦 Oshige Akihiko
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 小田 耕平 Oda Kohei
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences
    • 今中 大 Imanaka Dai
    • 鹿児島大学大学院医歯学総合研究科消化器疾患・生活習慣病学 Digestive Disease and Life-style Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences

Abstract

症例1は80歳,男性.2007年肝細胞癌に対して開腹下ラジオ波焼灼療法(RFA)を施行して以降,多発再発に対して肝動注化学塞栓療法(TACE)にて繰り返し加療していた.2013年完全房室ブロックに対してペースメーカー植込み術が行われた.2014年4月肝S4の肝細胞癌再発に対して,バイポーラ電極針2本にてRFAを施行した.焼灼中はペースメーカー設定をVVI modeからVOO modeに変更した.症例2は86歳,男性.2003年完全房室ブロックに対してペースメーカー植込み術が行われた.2014年1月肝S6の肝細胞癌に対して,TACEを施行後,バイポーラ電極針2本にてRFAを追加施行した.焼灼中はペースメーカーの設定(VDD mode)を変更しなかった.2症例共,焼灼中に心電図モニタ上に異常波形の出現は認めず,バイポーラ電極針を用いたRFAは,ペースメーカー植込み症例でも安全に施行できると考えられた.

Patient 1 was an 80-year-old man with recurrent hepatocellular carcinoma (HCC). Previously, his HCC had been treated with transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) using a monopolar electrode. In 2013, a pacemaker was implanted to treat complete atrioventricular block. In April 2014, he underwent RFA using two bipolar electrodes to treat recurrent HCC. During ablation, the pacing mode was changed from VVI to VOO. Patient 2 was an 86-year-old man who received a pacemaker for complete atrioventricular block in 2003. In 2014, he underwent TACE for HCC followed by RFA using two bipolar electrodes. The pacing mode (VDD) was not changed during ablation. In both patients, we did not observe any abnormal waveforms with electrocardiographic monitoring or pacing failure during ablation. These results suggest that treating HCC using RFA with bipolar electrodes is safe in patients with pacemakers.

Journal

  • Kanzo

    Kanzo 56(2), 57-64, 2015

    The Japan Society of Hepatology

Codes

  • NII Article ID (NAID)
    130004897353
  • NII NACSIS-CAT ID (NCID)
    AN00047770
  • Text Lang
    JPN
  • ISSN
    0451-4203
  • NDL Article ID
    026195887
  • NDL Call No.
    Z19-130
  • Data Source
    NDL  J-STAGE 
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