Department of Hepatobiliary and Pancreatic Surgery, Leicester Royal Infirmary, Leicester, UK.
Am J Surg. 2010 Oct;200(4):500-6. doi: 10.1016/j.amjsurg.2009.12.025.
Cytokine changes after microwave tissue ablation (MTA) were compared with hepatic resection, cryotherapy (CRYO), and radiofrequency ablation (RFA). Cytokine production was measured at various ablation volumes for each modality and correlated with the transitional inflammatory zone produced by the ablation techniques.
Live rats underwent MTA, surgical resection, CRYO or RFA of 15%, 33%, or 66% of the total hepatic volume. Serum samples were collected preoperatively and at 1, 3, 6, 24, and 48 hours after surgery and analyzed for pro-inflammatory cytokines interleukin (IL)-1β and IL-6.
Significantly higher levels of both cytokines were present after CRYO and RFA compared with MTA, hepatic resection, or controls (P < .001). All animals survived except those undergoing RFA or CRYO of 66% of the hepatic volume, which died within 6 hours. Transitional zones produced after RFA were larger than those after CRYO or MTA, but no correlation was present with the amount of cytokines.
Large-volume MTA is associated with a significant decreased cytokine response and is well tolerated compared with RFA and CRYO.
比较了微波组织消融(MTA)后细胞因子的变化与肝切除术、冷冻疗法(CRYO)和射频消融(RFA)。测量了每种模式下不同消融体积的细胞因子产生情况,并将其与消融技术产生的过渡性炎症区相关联。
活大鼠接受 MTA、手术切除、CRYO 或 RFA,分别切除肝脏总容积的 15%、33%或 66%。术前及术后 1、3、6、24 和 48 小时采集血清样本,分析促炎细胞因子白细胞介素(IL)-1β和 IL-6。
与 MTA、肝切除术或对照组相比,CRYO 和 RFA 后两种细胞因子的水平均显著升高(P <.001)。除接受 RFA 或 CRYO 切除肝脏总容积 66%的大鼠在 6 小时内死亡外,所有动物均存活。RFA 后产生的过渡区大于 CRYO 或 MTA 后产生的过渡区,但与细胞因子的量无关。
与 RFA 和 CRYO 相比,大容量 MTA 与细胞因子反应显著降低相关,且耐受性良好。