Miroslav Ilic, Aleksandar Milovancev, Milos Koledin, Brane Gavrancic, Violetta Raffay
Institute for Lung Disease of Vojvodina, Clinic for Thoracic Surgery, Sremska Kamenica, Serbia.
J Med Life. 2009 Jan-Mar;2(1):42-52.
The aim of this paper is to determine the possibilities of modern radiofrequency (RF) technology and the usefulness of abdominal and thoracic parenchymatous organs in surgery. Investigation was made on 17 patients with 125 RF energy realized cycles (an average of 7.35 per one pt.) and the average time heating coagulative necrosis of 42.6 minutes (maximum to 80 minutes). There was one complication (pleural effusion) in a patient with RF treatment of 5 metastases colorectal carcinoma (MCRC) and synchronous right hemicolectomy. There were no other complications either to close or to distant to the organs. The urgent need of RF technology was in the case of a patient with iatrogenic rupture of spleen, treated by radiofrequency coagulation (RFC) with documented preservation of the whole organ. Most of the patients with MCRC (64%) were intraoperatively treated with a combination of radiofrequency ablation (RFA) and radiofrequency assisted resection (RFAR) of the liver with success in 95% of the cases. In the surgery of echinococcal liver cyst located deep, in the parenchyma, RFA were used for scolicidal purpose, and for hepatotomy. In the treatment of lung malignancies RF technology was reserved for nonsurgical candidates suffering from NSCLC, but also for surgical patients as a palliative measure in the treatment of local symptoms related to non-resectable primary and secondary tumors, presenting an aggressive tumor growth on the thoracic wall and the great vessels, with the possibility of reducing the number of explorative thoracotomy.
本文旨在确定现代射频（RF）技术的可能性以及腹部和胸部实质器官在手术中的实用性。对17例患者进行了研究，共实现125个射频能量周期（平均每例患者7.35个周期），平均热凝坏死时间为42.6分钟（最长80分钟）。1例接受5处转移性结直肠癌（MCRC）射频治疗并同期行右半结肠切除术的患者出现了1例并发症（胸腔积液）。在器官附近或远处均未出现其他并发症。对于1例医源性脾破裂患者，迫切需要射频技术，经射频凝固（RFC）治疗后，该器官得以完整保留。大多数MCRC患者（64%）在术中接受了射频消融（RFA）和肝脏射频辅助切除（RFAR）联合治疗，95%的病例取得成功。对于位于肝实质深部的肝包虫囊肿手术，RFA用于杀头节及肝切开术。在肺癌治疗中，RF技术适用于非小细胞肺癌（NSCLC）的非手术候选患者，也适用于手术患者，作为治疗与不可切除的原发性和继发性肿瘤相关的局部症状的姑息措施，这些肿瘤在胸壁和大血管上呈侵袭性生长，有可能减少探索性开胸手术的次数。
