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绵羊肝脏内射频消融辅助横断术的对照研究

Controlled study of inline radiofrequency ablation (ILRFA) assisted transection of ovine liver.

作者信息

Haghighi Koroush S, Steinke Karin, Hazratwala Kiran, Kam Peter C A, Daniel Steven, Morris David L

机构信息

University of New South Wales Department of Surgery, St George Hospital, Sydney, Australia.

出版信息

J Surg Res. 2005 Jan;123(1):139-43. doi: 10.1016/j.jss.2004.07.021.

Abstract

BACKGROUND

Liver resection is now a standard treatment for primary and secondary hepatic tumors around the world. Intra-operative blood loss during liver resection is a major factor associated with morbidity and mortality. We have developed a new instrument using radiofrequency energy (ILRFA), which is intended to achieve coagulative ablation in a plane. This plane can then be cut through with a scalpel, ultrasonic dissector, or diathermy with minimal blood loss.

MATERIALS AND METHODS

Five sheep were used in this non-recovery experiment. In these sheep we performed five liver resections with the ILRFA and five similar resections using diathermy and suturing as control. Blood loss was measured by determining the difference in the weights of dry sponges and blood stained sponges after resection.

RESULTS

ILRFA was successful in achieving coagulative ablation in all cases to a width of 1 cm. The mean blood loss in ILRFA was 43.2 g (SD36) and 221.8 g (SD147) in the control group. The bleeding was significantly reduced in ILRFA group with a P value of 0.005.

CONCLUSIONS

Bleeding remains an important complication of liver resection. To reduce bleeding during liver surgery, different techniques have been used. In this study, we have demonstrated that by using ILRFA we can perform liver resections in sheep with minimal blood loss.

摘要

背景

肝切除术目前是全球原发性和继发性肝肿瘤的标准治疗方法。肝切除术中的术中失血是与发病率和死亡率相关的主要因素。我们开发了一种使用射频能量的新器械(ILRFA),旨在在一个平面上实现凝固性消融。然后可以用手术刀、超声解剖器或透热法切开这个平面,使失血最少。

材料与方法

在这个非恢复性实验中使用了5只绵羊。在这些绵羊身上,我们用ILRFA进行了5次肝切除术,并使用透热法和缝合作为对照进行了5次类似的切除术。通过测定切除后干海绵和血染海绵的重量差异来测量失血量。

结果

ILRFA在所有病例中均成功实现了1厘米宽度的凝固性消融。ILRFA组的平均失血量为43.2克(标准差36),对照组为221.8克(标准差147)。ILRFA组的出血明显减少,P值为0.005。

结论

出血仍然是肝切除的一个重要并发症。为了减少肝脏手术中的出血,人们使用了不同的技术。在本研究中,我们证明了通过使用ILRFA,我们可以在绵羊身上进行肝切除术,使失血量最少。

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