Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY, USA.
Ann Surg Oncol. 2009 Nov;16(11):3057-63. doi: 10.1245/s10434-009-0688-x.
Microwave energy is another energy source than can be used to precoagulate hepatic tissue during hepatic resection. The aim of this study was to develop an optimal microwave precoagulation technique in a porcine model and then validate the technique during hepatic resection in patients.
Institutional Animal Care and Use and Institutional Review Board (IRB)-approved protocols were utilized for hepatic resection in a porcine model and validation in patients using microwave energy for precoagulation. Different numbers of antennas (one, two or three; spaced 5 mm apart) and ablation times (20, 30, 40, and 60 s) were evaluated to identify an optimal technique that effectively provided precoagulation.
Animal studies: Two antennas for 30 s provided the optimal ablation time, ablation width, mean size of largest vessel coagulated, and minimal bleeding when compared with other techniques. However, given that this is not an optimal technique for laparoscopic precoagulation, one antenna for 60 s was found to provide similar precoagulation success. Patient validation: To validate these techniques, three patients underwent open hepatectomy using two antennas with 5 mm spacing for 30 s, demonstrating successful precoagulation up to inflow/outflow vessels of 10 mm size or greater, which were controlled with a vascular stapler. In addition three patients underwent laparoscopic hepatectomy using one antenna for 60 s and demonstrated successful precoagulation up to inflow/outflow vessels of 8 mm or greater, which were controlled with a vascular stapler.
Microwave energy is a safe and effective precoagulation device to achieve good hemostasis during hepatic resection with both open and laparoscopic technique.
微波能量是另一种可用于肝切除术中预凝结肝组织的能源。本研究的目的是在猪模型中开发一种最佳的微波预凝结技术，然后在患者的肝切除术中验证该技术。
使用微波能量进行预凝结的机构动物护理和使用以及机构审查委员会 (IRB) 批准的方案在猪模型中进行肝切除术，并在患者中进行验证。评估了不同数量的天线（一个、两个或三个；间隔 5 毫米）和消融时间（20、30、40 和 60 秒），以确定一种有效的最佳技术来提供预凝结。
动物研究：与其他技术相比，两个天线 30 秒提供了最佳的消融时间、消融宽度、凝固的最大血管平均尺寸和最小出血。然而，鉴于这不是腹腔镜预凝结的最佳技术，发现一个天线 60 秒提供了类似的预凝结成功率。患者验证：为了验证这些技术，三名患者接受了开放性肝切除术，使用两个天线，间隔 5 毫米，消融时间为 30 秒，成功地预凝结了 10 毫米或更大的流入/流出血管，这些血管用血管吻合器控制。此外，三名患者接受了腹腔镜肝切除术，使用一个天线 60 秒，成功地预凝结了 8 毫米或更大的流入/流出血管，这些血管用血管吻合器控制。
微波能量是一种安全有效的预凝结设备，可在开放和腹腔镜技术下实现肝切除术中的良好止血。
