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半球形射频双极装置——一种肝切除新技术:猪模型体内实验研究

Semi-spherical Radiofrequency Bipolar Device - A New Technique for Liver Resection: Experimental In Vivo Study on the Porcine Model.

作者信息

Vavra P, Penhaker M, Jurcikova J, Skrobankova M, Crha M, Ostruszka P, Ihnat P, Grepl J, Delongova P, Dvorackova J, Prochazka V, Salounova D, Skoric M, Rauser P, Habib N, Zonca P

机构信息

Department of Surgery, University Hospital Ostrava, the Czech Republic Department of Cybernetics and Biomedical Engineering, Faculty of Electrical Engineering and Computer Science, VŠB-Technical University of Ostrava, the Czech Republic Department of Surgery, Medical Faculty, Ostrava University, the Czech Republic Liver and Pancreas Surgery, Hammersmith Hospital, Imperial College London, United Kingdom

Department of Cybernetics and Biomedical Engineering, Faculty of Electrical Engineering and Computer Science, VŠB-Technical University of Ostrava, the Czech Republic.

出版信息

Technol Cancer Res Treat. 2015 Oct;14(5):573-82. doi: 10.7785/tcrt.2012.500432. Epub 2014 Nov 26.

Abstract

The incidence of colorectal carcinoma is still growing in the Czech Republic and also all around the world. With success of oncological treatment is also growing a number of potential patients with liver metastases, who can profit from surgical therapy. The aim of this study was to confirm on porcine models that this method by using new surgical device is effective and safe for patients who have to undergo liver resection. The primary hypothesis of the study was to evaluate whether this new device is able to consistently produce homogeneous and predictable areas of coagulation necrosis without the Pringle maneuver of vascular inflow occlusion. The secondary hypothesis of the study was to compare the standard linear radiofrequency device and a new semi-spherical bipolar device for liver ablation and resection in a hepatic porcine model. Twelve pigs were randomly divided into two groups. Each pig underwent liver resection from both liver lobes in the marginal, thinner part of liver parenchyma. The pigs in first group were operated with standard using device and in the second group we used new developed semi-spherical device. We followed blood count in 0(th), 14(th) and 30(th) day from operation. 14(th) day from resection pigs underwent diagnostic laparoscopy to evaluate of their state, and 30(th) day after operation were all pigs euthanized and subjected to histopathological examination. Histopathological evaluation of thermal changes at the resection margin showed strong thermal alteration in both groups. Statistical analysis of collected dates did not prove any significant (p < 0.05) differences between standard using device and our new surgical tool. We proved safety of new designed semi-spherical surgical. This device can offer the possibility of shortening the ablation time and operating time, which is benefit for patients undergoing the liver resection.

摘要

在捷克共和国以及全世界,结直肠癌的发病率仍在上升。随着肿瘤治疗的成功,有肝转移的潜在患者数量也在增加,这些患者可以从手术治疗中获益。本研究的目的是在猪模型上证实,使用这种新的手术器械的方法对必须接受肝切除术的患者是有效且安全的。该研究的主要假设是评估这种新器械是否能够在不进行血管流入阻断的普林格尔手法的情况下,始终产生均匀且可预测的凝固性坏死区域。该研究的次要假设是在猪肝模型中比较标准线性射频器械和一种新的半球形双极器械用于肝脏消融和切除的效果。12头猪被随机分为两组。每头猪均在肝实质边缘较薄的部分对两个肝叶进行肝切除。第一组猪使用标准器械进行手术,第二组使用新开发的半球形器械。我们在术后第0天、第14天和第30天对血常规进行跟踪。切除术后第14天,猪接受诊断性腹腔镜检查以评估其状态,术后第30天,所有猪均实施安乐死并进行组织病理学检查。切除边缘热变化的组织病理学评估显示两组均有强烈的热改变。对收集数据的统计分析未证明使用标准器械和我们的新手术工具之间存在任何显著(p<0.05)差异。我们证明了新设计的半球形手术器械的安全性。该器械可以提供缩短消融时间和手术时间的可能性,这对接受肝切除术的患者有益。

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