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Microwave Ablation of the Liver

Thermal destruction of liver tumors using microwave energy

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Microwave Ablation of the Liver?

Microwave ablation generates frictional heat in tissue water molecules using electromagnetic waves at 915 MHz or 2.45 GHz, raising tissue temperature above 60 degrees Celsius to cause coagulative necrosis.

MWA produces larger and more uniform ablation zones than radiofrequency ablation, with less susceptibility to heat-sink effects from blood vessels.

Indications include hepatocellular carcinoma (HCC) up to 3–5 cm, oligometastatic colorectal liver metastases, and other primary or secondary liver tumors not amenable to surgery.

Approaches include percutaneous (most common, image-guided), laparoscopic and open surgical placement of antennae.

MWA can be combined with chemoembolization, radioembolization or systemic therapy depending on tumor biology and burden.

Symptoms

Indications: HCC in cirrhotic patients within Milan criteria not suitable for surgery or transplantation, oligometastatic disease (especially colorectal liver metastases)
Pre-procedure: tumor stage, hepatic function (Child-Pugh), comorbidities, prior treatments inform decision
Post-ablation symptoms: low-grade fever, abdominal discomfort, mild pain (post-ablation syndrome) for 1–7 days
Warning signs: high fever, severe pain, jaundice, signs of bleeding, deteriorating liver function, infection
Long-term symptoms: recurrent disease in liver, signs of metastasis or worsening cirrhosis

Risk Factors

Indications: limited liver tumor burden (typically up to 3 lesions, each less than 5 cm), absence of extrahepatic disease (or controlled extrahepatic disease)
Patient factors: Child-Pugh A or B liver function, ECOG performance status 0–2, no contraindication to anesthesia
Risks: bleeding, infection, biloma, abscess, pleural effusion, tumor seeding (rare), liver failure in advanced cirrhosis
Tumor factors: location near major bile ducts increases risk of bile duct injury; subcapsular location increases bleeding risk
Contraindications: extensive extrahepatic disease, severe coagulopathy, advanced liver decompensation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • High fever above 38.5 degrees beyond a few days post-ablation
  • Severe persistent abdominal pain not relieved by analgesics
  • Jaundice, dark urine or worsening liver function
  • Signs of bleeding: weakness, dizziness, abdominal distension
  • Persistent vomiting or inability to tolerate diet
  • Signs of infection or abscess: chills, increasing pain, drainage from puncture site
  • Dyspnea or chest pain suggesting pleural effusion
  • New symptoms suggesting recurrent or progressive disease

Treatment Methods

01
Pre-procedure assessment: triphasic CT or MRI, AFP for HCC, liver function tests, coagulation profile
02
Multidisciplinary review (hepatology, surgery, oncology, interventional radiology) to confirm MWA appropriateness
03
Procedure performed under conscious sedation or general anesthesia, typically percutaneous with ultrasound or CT guidance
04
Place microwave antennae into tumor under image guidance; multiple antennae may be used for larger lesions
05
Apply microwave energy for 5–10 minutes per antenna with target temperature exceeding 60 degrees throughout the tumor plus a 0.5–1 cm safety margin
06
Monitor with real-time imaging; assess immediate post-ablation contrast-enhanced CT for completeness
07
Track ablation cavity post-procedure to confirm absence of residual viable tumor
08
Follow-up imaging at 1, 3, 6 and 12 months with contrast-enhanced CT or MRI
09
Manage pain with NSAIDs (avoiding in cirrhosis), opioids if severe; antibiotic prophylaxis only when indicated
10
Repeat ablation, surgery, transplantation or systemic therapy for recurrent or progressive disease

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.