Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2017; 9(12): 281-287
Published online Dec 27, 2017. doi: 10.4240/wjgs.v9.i12.281
Surgically treated diaphragmatic perforation after radiofrequency ablation for hepatocellular carcinoma
Sachiko Nagasu, Koji Okuda, Ryoko Kuromatsu, Yoriko Nomura, Takuji Torimura, Yoshito Akagi
Sachiko Nagasu, Yoshito Akagi, Department of Gastrointestinal Surgery, Kurume University, Fukuoka 8300011, Japan
Koji Okuda, Yoriko Nomura, Department of Hepato-biliary and Pancreatic Surgery, Kurume University, Fukuoka 8300011, Japan
Ryoko Kuromatsu, Takuji Torimura, Department of Gastroenterological Medicine, Kurume University, Fukuoka 8300011, Japan
Author contributions: Nagasu S and Okuda K made substantial contributions to the conception or design of the work, the acquisition, analysis, and interpretation of data for the work; Okuda K, Kuromatsu R, Nomura Y, Torimura T and Akagi Y contributed to the drafting of the work or revising it critically for important intellectual content; all authors provided final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Informed consent statement: This is a retrospective study, as we are taking personal information measures, there is no possibility of suffering disadvantages.
Conflict-of-interest statement: No conflict-of-interest was available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sachiko Nagasu, PhD, Department of Gastrointestinal Surgery, Kurume University, 67 Asahi-machi Kurume, Fukuoka 8300011, Japan. shiraiwa_sachiko@med.kurume-u.ac.jp
Telephone: +81-942-353311 Fax: +81-942-326278
Received: August 7, 2017
Peer-review started: August 8, 2017
First decision: September 7, 2017
Revised: September 18, 2017
Accepted: November 25, 2017
Article in press: November 25, 2017
Published online: December 27, 2017
Core Tip

Core tip: Diaphragmatic perforation after radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) has been rarely described in the literature; however, it is one of the most serious complications. We conducted a retrospective analysis of 6 cases of diaphragmatic perforation after RFA, and considered the following 3 causative factors for this complication: Location, thermal damage, and liver cirrhosis. Moreover, we found that this complication tends to develop late after RFA. We propose that diaphragmatic perforation after RFA is a rare complication. Clinicians should take steps to prevent thermal injury to the diaphragm by performing RFA for HCC adjacent to the diaphragm and carefully follow up after RFA.