Endoscopic ultrasound-guided application of a new internally gas-cooled radiofrequency ablation probe in the liver and spleen of an animal model: a preliminary study

被引:38
作者
Carrara, S. [1 ]
Arcidiacono, P. G. [1 ]
Albarello, L. [2 ]
Addis, A. [3 ]
Enderle, M. D. [4 ]
Boemo, C. [1 ]
Neugebauer, A. [4 ]
Campagnol, M. [3 ]
Doglioni, C. [2 ]
Testoni, P. A. [1 ]
机构
[1] Univ Vita Salute San Raffaele, Div Gastroenterol & Gastrointestinal Endoscopy, I-20132 Milan, Italy
[2] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Dept Pathol, I-20132 Milan, Italy
[3] Univ Milan, Res Ctr Biotechnol Applicat Cardiovasc Surg, Milan, Italy
[4] ERBE Elektromed GmbH, Res Dept, Tubingen, Germany
关键词
D O I
10.1055/s-2008-1077520
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and study aims: In a previous study, a new flexible bipolar hybrid cryotherm probe was applied with success to the pancreas of a living pig. Here we evaluated feasibility, efficacy, and safety of its application to the porcine liver and spleen. Material and methods: Ten applications to the liver and nine to the spleen were performed in 19 pigs. Power input (16 - 18 W) and simultaneous cooling with CO(2) (standardized pressure: 675psi) as the cryogenic agent were investigated. Application time varied from 120 seconds to 900 seconds. The ablation area was measured by endoscopic ultrasound (EUS) after ablation (T0), and before euthanasia (T1). Gross pathology (T2) and histology after necropsy represented the gold standard. The interval from treatment to euthanasia was 1 or 2 weeks. Results: For both organs the correlation between EUS and gross pathology was good (correlation coefficient R(liver) = 0.71; R(spleen) = 0.73). EUS tended to overestimate the area of the ablated zone. EUS observed a time-dependent ablation area: we demonstrated a positive trend of lesion size (T1) over time in liver tissue (R = 0.51 (P = 0.1)). In the spleen we found a clear correlation of lesion area T2 and application time (R = 0.75, P = 0.01). There were no complications. Conclusions: Selective EUS-guided transgastric cryotherm ablation of the liver and spleen in a pig model is feasible and safe. The new bipolar probe creates a time-dependent ablation area without any complications, and opens a field of new potential indications of RF-ablative therapies.
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页码:759 / 763
页数:5
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