Dobbins Christopher, Wemyss-Holden Simon A, Cockburn John, Maddern Guy J
Discipline of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Woodville, South Australia, Australia.
J Surg Res. 2008 Jan;144(1):111-6. doi: 10.1016/j.jss.2007.03.066. Epub 2007 Jul 19.
Radiofrequency ablation (RFA) is a method of treating non-resectable liver tumors by use of a high-frequency alternating electrical current. Concerns have been raised as the local recurrence rates following treatment have been reported to be as high as 47%. The size of the ablation is limited by charring of adjacent tissues. It is hypothesized that by hydrating the liver, we can reduce charring, thus producing larger ablations, and that this can be achieved by addition of a direct electrical current to the electrical circuit. Using a pig model, standard RFA control ablations were created in the left lobe of the liver. Ablations using the modified circuit were created in the right lobe. At the end of the procedure, the pig was killed by lethal injection and the liver harvested. From the explanted liver, the diameter of each ablation was measured and the modified ablations were compared with controls using restricted maximum likelihood variance analysis. From 4 pigs, 14 controls and 12 modified ablations were produced. The mean diameter of the controls was 27.78 mm (+/- SE 3.37 mm). The mean diameter of the modified ablation was 49.55 mm (+/- SE 3.46 mm), which was significantly larger than the controls (P < 0.001). This study has shown that by modification of the standard RFA circuit with the addition of a direct electrical current, significantly larger ablations can be produced. By using this technique, the number of ablations required to treat one tumor would be less and it is anticipated this could reduce the rate of local recurrence.
射频消融术（RFA）是一种通过使用高频交流电来治疗不可切除肝脏肿瘤的方法。由于据报道治疗后的局部复发率高达47%，人们对此产生了担忧。消融的大小受到相邻组织碳化的限制。据推测，通过给肝脏补水，我们可以减少碳化，从而产生更大的消融范围，并且这可以通过在电路中添加直流电来实现。使用猪模型，在肝脏左叶进行标准RFA对照消融。在右叶进行使用改良电路的消融。手术结束时，通过致命注射处死猪并摘取肝脏。从取出的肝脏中，测量每个消融的直径，并使用限制最大似然方差分析将改良消融与对照进行比较。从4头猪中，产生了14个对照消融和12个改良消融。对照消融的平均直径为27.78毫米（±标准误3.37毫米）。改良消融的平均直径为49.55毫米（±标准误3.46毫米），明显大于对照（P < 0.001）。这项研究表明，通过在标准RFA电路中添加直流电进行改良，可以产生明显更大的消融范围。通过使用这种技术，治疗一个肿瘤所需的消融次数会减少，并且预计这可以降低局部复发率。
