Berber Eren
Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, OH, USA.
HPB (Oxford). 2015 Jul;17(7):632-6. doi: 10.1111/hpb.12423. Epub 2015 May 16.
Liver tumour ablation is an operator-dependent procedure. The determination of the optimum needle trajectory and correct ablation parameters could be challenging. The aim of this study was to report the utility of a new, procedure planning software for microwave ablation (MWA) of liver tumours.
This was a feasibility study in a pilot group of five patients with nine metastatic liver tumours who underwent laparoscopic MWA. Pre-operatively, parameters predicting the desired ablation zones were calculated for each tumour. Intra-operatively, this planning strategy was followed for both antenna placement and energy application. Post-operative 2-week computed tomography (CT) scans were performed to evaluate complete tumour destruction.
The patients had an average of two tumours (range 1-4), measuring 1.9 ± 0.4 cm (range 0.9-4.4 cm). The ablation time was 7.1 ± 1.3 min (range 2.5-10 min) at 100W. There were no complications or mortality. The patients were discharged home on post-operative day (POD) 1. At 2-week CT scans, there were no residual tumours, with a complete ablation demonstrated in all lesions.
This study describes and validates pre-treatment planning software for MWA of liver tumours. This software was found useful to determine precisely the ablation parameters and needle placement to create a predicted zone of ablation.
肝脏肿瘤消融是一种依赖操作者的操作。确定最佳针道轨迹和正确的消融参数可能具有挑战性。本研究的目的是报告一种用于肝脏肿瘤微波消融(MWA)的新型手术规划软件的实用性。
这是一项针对5例患有9个肝转移瘤的患者的试点组进行的可行性研究,这些患者接受了腹腔镜MWA。术前,为每个肿瘤计算预测所需消融区域的参数。术中,在天线放置和能量应用方面均遵循该规划策略。术后2周进行计算机断层扫描(CT)以评估肿瘤是否被完全破坏。
患者平均有两个肿瘤(范围1 - 4个),大小为1.9±0.4厘米(范围0.9 - 4.4厘米)。在100W功率下,消融时间为7.1±1.3分钟(范围2.5 - 10分钟)。无并发症或死亡。患者在术后第1天出院回家。术后2周CT扫描显示无残留肿瘤,所有病变均实现完全消融。
本研究描述并验证了用于肝脏肿瘤MWA的术前规划软件。发现该软件有助于精确确定消融参数和针的放置,以创建预测的消融区域。