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评价一种新型内镜应用射频消融胆管导管在离体猪肝中的效果。

Evaluation of effects of a novel endoscopically applied radiofrequency ablation biliary catheter using an ex-vivo pig liver.

机构信息

Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.

出版信息

J Hepatobiliary Pancreat Sci. 2012 Sep;19(5):543-7. doi: 10.1007/s00534-011-0465-7.

Abstract

BACKGROUND

The effects of ablation with various settings of powers and times using a newly developed radiofrequency (RF) ablation device, the Habib™ EndoHPB catheter, are not well known. In the present study, we examined the effects of a novel RF ablation catheter using resected fresh pig livers and evaluated the macro- and microscopic effects of RF ablation under various conditions.

MATERIALS AND METHODS

The RF application was performed step by step at 5, 10, 15, and 20 W power and 60, 90, 120 s, respectively. Macroscopic and microscopic findings of the ablation area were evaluated at each setting.

RESULTS

The mean lengths of the short axis of the ablation area at 10 W and 60, 90 and 120 s were 8.0 ± 1.0, 8.3 ± 1.2, and 9.7 ± 0.6 mm, respectively. The mean lengths of the long axis at 10 W power and 60, 90 and 120 s were 20.3 ± 0.6, 21.3 ± 1.6, and 28.3 ± 2.1 mm, respectively. Although the lengths of the short and long axes at 5 and 10 W increased gradually with power, there were no obvious differences in either short or long axis lengths between 15 and 20 W. Of all the settings, only at 5 W and 60 and 90 s did the long axis of the ablation show separate areas around the 2 ring electrodes.

CONCLUSIONS

Although other sequelae including hemorrhage, pancreatitis, acute inflammatory changes, perforation and late fibrosis could not be investigated in our ex-vivo pig model, our study clarified the relationship between ablation powers and times and the effects concerning depth and longitudinal spread of ablation. Although the clinical ablation setting at 7-10 W power and 2 min is suitable, ultimately the ablation power and time should be adjusted according to the size of masses using examples from the present results.

摘要

背景

使用新型射频(RF)消融设备 Habib™EndoHPB 导管,各种功率和时间设置的消融效果尚不清楚。本研究使用新鲜猪肝评估新型 RF 消融导管的效果,并在各种条件下评估 RF 消融的宏观和微观效果。

材料和方法

分别以 5、10、15 和 20 W 功率和 60、90 和 120 s 进行逐步 RF 应用,分别在每个设定点评估消融区域的宏观和微观发现。

结果

在 10 W 和 60、90 和 120 s 时,消融区域短轴的平均长度分别为 8.0±1.0、8.3±1.2 和 9.7±0.6mm。在 10 W 功率和 60、90 和 120 s 时,长轴的平均长度分别为 20.3±0.6、21.3±1.6 和 28.3±2.1mm。尽管在 5 和 10 W 时,短轴和长轴的长度随着功率的增加而逐渐增加,但在 15 和 20 W 之间,短轴或长轴的长度没有明显差异。在所有设定中,只有在 5 W 和 60、90 s 时,消融的长轴在两个环电极周围显示出单独的区域。

结论

尽管在我们的离体猪模型中不能研究包括出血、胰腺炎、急性炎症变化、穿孔和晚期纤维化在内的其他后遗症,但本研究阐明了消融功率和时间与消融深度和纵向扩展的关系。虽然在 7-10 W 功率和 2 分钟的临床消融设置是合适的,但最终消融功率和时间应根据本研究结果的肿块大小进行调整。

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