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Objective To investigate the relationship between tumor location and pain level in computed tomography (CT) - guided percutaneous microwave ablation ( MWA) of hepatocellular carcinoma ( HCC) under local anesthesia. Methods A total of 42 tumors in 35 HCC patients were given CT - guided percutaneous MWA under local anesthesia after transcatheter hepatic arterial chemoembolization. The 35 patients were divided into two groups based on the distance from the tumor to the Glisson's capsule and/ or the branch of the portal vein. Group A ( 19 tumors out of 16 patients) had a distance of ≤5 mm from the tumor to the Glisson's capsule and/ or the branch of the portal vein, and group B (23 tumors out of 19 patients) had a distance of >5 mm from the tumor to both the Glissons capsule and the branch of the portal vein. The pain levels of the two groups were evaluated by visual analogue scale (VAS). The tumor size, baseline VAS score, intraoperative VAS score ( the highe st VAS score during MWA ), relative VAS score ( intraoperative VAS score minus baseline VAS score ), the highe st tolerated MWA power, ablation time, and meperidine hydrochloride dose were recorded and compared between the two groups. The comparison was made by Mann - Whitney U test. Results The 16 cases in group Ahad significantly higher intraoperative VAS score and relative VAS score than the 19 cases in group B (3.25 ±0.68 vs 2.74 ± 0.73, P = 0.042; 3.00 ± 0.52 vs 2.47 ± 0.61, P = 0.009). It showed that the patients whose tumor was close to the Glisson's capsule had a greater pain level than the patients whose tumor was away from the Glisson's capsule. The dose of meperidine hydrochloride in group A was significantly higher than that in group B (78.1 ± 20.2 mg vs 64.5 ± 17.3 mg, P = 0.039). After treatment with high dose of meperidine hydrochloride, groups A and B showed no significant differences in the highest tolerated MWA power and ablation time (73.8 ± 15.4 W vs 75.8 ± 17.7 W, P > 0.05 ; 6.6 ± 1.8 min vs 6.4 ± 2.1 min, P > 0.05). Conclusion The patients who have a longer distance between the tumor and the Glisson's capsule and the branch of the portal vein suffer greater pain in MWA therapy. Additional meperidine hydrochloride can help complete the MWA treatment. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy of short - term nutritional intervention in patients with primary hepatocellular carcinoma treated by transcatheter arterial chemoembolization. Methods Sixty patients with primary hepatocellular carcinoma who were admitted to Beijing Youan Hospital to receive transcatheter arterial chemoembolization from January 2012 to October 2012 were equally and non - randomly divided into two groups : nutrition group and control group. The two groups were all given nutrition guidance after transcatheter arterial chemoembolization. The nutrition group was given 15 g liver essentials twice a day (one in the morning and the other in the evening) by oral administration for 4 weeks, while the control group was given routine diet for 4 weeks. Comparison of data between the two groups was made by independent - samples t test. Results After 4 weeks of continuous treatment, the two groups had significantly increased body weight (P < 0.05), arm muscle circumference (P < 0. 05), and triceps skinfold thickness (P < 0. 05) . The two groups had significantly increased total protein (67 ± 13 g/L vs 72 ± 9 g/L, P = 0.04; 66 ± 10 g/L vs 74 ± 8 g/L, P = 0.02) after treatment, and there was a significant diiference in changes in total protein after treatment between the two groups (P = 0.04). The nutrition group had significantly increased albumin (34.7 ± 2.9 g/L vs 39.9 ± 3.5 g/L, P = 0.03) and cholinesterase (3342 ± 415 U/L vs 4600 ± 459 U/L, P = 0.01) after treatment, and there was a significant diiference in changes in albumin (P = 0.03) and cholinesterase (P = 0.03) after treatment between the two groups. Conclusion For patients with primary hepatocellular carcinoma treated by transcatheter arterial chemoembolization, oral administration of liver essentials improves their nutritional status and liver function, so as to increase their tolerance to subsequent treatments. [ABSTRACT FROM AUTHOR]