Department of Surgery, Rode Island Hospital and Warren Alpert School of Medicine at Brown University, Providence, RI, USA.
HPB (Oxford). 2011 Mar;13(3):168-73. doi: 10.1111/j.1477-2574.2010.00261.x. Epub 2011 Jan 25.
Irreversible electroporation (IRE) is a novel, non-thermal form of ablation. We studied the safety and efficacy of IRE for the ablation of liver tissue around the liver hilum. We also studied the ability of triphenyltetrazolium chloride staining (TTC) to predict the zone of ablation after IRE.
Eight swine underwent 20 ablations of the liver and liver hilum. Two monopolar probes were positioned 2 cm apart. IRE was performed using 90 pulses of 2500-3000 V/cm. IRE treatments were performed from 15 min to 14 days (n= 4) before sacrifice.
All animals survived. No major complications were encountered. Ablation width ranged from 2.27 to 4.45 cm and ablation height ranged from 1.5 to 1.8 cm. TTC staining demonstrated the zone of ablation in all animals. Hepatocyte necrosis occurs immediately adjacent to large central veins without evidence of heat sink. Bile ducts, portal veins and hepatic arteries appear to be more resistant to the effects of IRE.
IRE appears to be safe and effective for liver tissue ablation in the liver hilum. The portal structures appear more resistant to the effects of IRE. TTC staining can predict the zone of IRE ablation as early as 15 min after treatment.
不可逆电穿孔(IRE)是一种新型的非热消融形式。我们研究了 IRE 消融肝门周围肝组织的安全性和有效性。我们还研究了三苯基四氮唑氯化物染色(TTC)预测 IRE 后消融区域的能力。
8 头猪进行了 20 次肝和肝门消融。两个单极探头相隔 2 厘米。使用 90 个 2500-3000V/cm 的脉冲进行 IRE。IRE 治疗在牺牲前 15 分钟至 14 天(n=4)进行。
所有动物均存活。未发生重大并发症。消融宽度为 2.27-4.45cm,消融高度为 1.5-1.8cm。TTC 染色显示所有动物均有消融区。肝细胞坏死紧邻大中央静脉发生,无热沉现象。胆管、门静脉和肝动脉似乎对 IRE 的影响更具抵抗力。
IRE 似乎是安全有效的,可用于肝门周围肝组织消融。门脉结构对 IRE 的影响更具抵抗力。TTC 染色可在治疗后 15 分钟内预测 IRE 消融区。