Gananadha Sivakumar, Morris David L
University of New South Wales Department of Surgery, St George Hospital, Sydney, Australia.
ANZ J Surg. 2004 Jun;74(6):482-5. doi: 10.1111/j.1445-1433.2004.03035.x.
Liver resection is widely used in the treatment of primary and secondary liver tumours. One of several important factors associated with mortality both in cirrhotic and non-cirrhotic patients after liver resection is operative blood loss. We evaluated the use of a prototype radiofrequency ablation probe to treat the transection plane prior to liver resection in the sheep model.
In-line radiofrequency ablation (RFA) was performed on the liver using a prototype device consisting of 11 electrodes mounted on a 8-cm base. The RITA 1500 generator was used for power delivery. Ultrasonic aspirator (UA) and clamp resection were performed on the liver of sheep with and without in-line RFA. The blood loss was measured by weighing swabs.
A total of 26 liver resections were performed. The mean (SD) blood loss with UA resection was 0.032 g (0.011) versus 0.005 (0.005) g without and with prior in-line RFA, respectively (P = 0.001). The mean (SD) blood loss with clamp resection was 0.087 (0.10) g versus 0.01 (0.008) without and with in-line RFA, respectively (P = 0.155).
In-line RFA makes liver resection easier with minimal blood loss and may make cirrhotic liver resection easier with minimal blood loss. This is likely to improve the operative safety of liver resection.
肝切除术广泛应用于原发性和继发性肝肿瘤的治疗。肝切除术后,肝硬化和非肝硬化患者死亡的几个重要因素之一是手术失血。我们在绵羊模型中评估了一种原型射频消融探头在肝切除术前处理肝断面的应用。
使用一个由安装在8厘米底座上的11个电极组成的原型设备对肝脏进行在线射频消融(RFA)。使用RITA 1500发生器进行能量输送。对进行和未进行在线RFA的绵羊肝脏分别进行超声吸引器(UA)和钳夹切除术。通过称量拭子来测量失血量。
共进行了26例肝切除术。UA切除时的平均(标准差)失血量为0.032克(0.011),未进行和进行在线RFA时分别为0.005(0.005)克(P = 0.001)。钳夹切除时的平均(标准差)失血量分别为0.087(0.10)克和0.01(0.008)克(未进行和进行在线RFA时)(P = 0.155)。
在线RFA使肝切除更容易,失血量最小,可能使肝硬化肝切除更容易,失血量最小。这可能会提高肝切除术的手术安全性。