Artificial ascites‑assisted microwave ablation for liver cancer adjacent to the diaphragm and perioperative nursing care.

Liver cancer near the deep diaphragm can be difficult to visualize due to the effects of lung gas, which presents a challenge for microwave ablation (MWA). The present study aimed to investigate the feasibility and efficacy of artificial ascites-assisted MWA for treating liver cancer near the deep diaphragm, as well as the significance of perioperative nursing. A retrospective analysis was conducted on patients who underwent artificial ascites-assisted MWA for liver cancer located near the deep diaphragm between January 2016 and December 2022. Normal saline was utilized as artificial ascites to safeguard the deep diaphragm during MWA. The study recorded the procedural success rate, incidence of major complications, technical efficacy of ablation and local tumor progression (LTP). A total of 62 lesions in 54 patients were included, with 44 men and 10 women, and a mean (± SD) age of 55.64±10.33 years. The ultrasound image quality scores for liver cancer before and after ascites were 3.57±0.79 and 4.89±0.33, respectively, showing a statistically significant difference between the two groups (t=16.324; P<0.05). No diaphragm injury, skin burns at the puncture site or abdominal hemorrhage occurred during the procedure. A single patient developed right-sided pleural effusion, which did not require drainage. The complete ablation rate was 94.4% (51/54) at 1 month post-ablation, with 3 patients experiencing recurrence and receiving additional MWA treatment. The median follow-up time for the patients in this study was 21 months (range, 12-45 months), with a LTP rate of 5.6% (3/54). In conclusion, MWA assisted by artificial ascites is a safe and effective treatment for liver cancer near the deep diaphragm. Furthermore, perioperative treatment and rehabilitation of the patients with high-quality nursing is beneficial.