Sánchez-Velázquez Patricia, Clavien Pierre-Alain
Departmento de cirugía y transplante, Hospital universitario de Zürich, Zúrich, Suiza.
Departmento de cirugía y transplante, Hospital universitario de Zürich, Zúrich, Suiza.
Cir Esp. 2017 Jun-Jul;95(6):307-312. doi: 10.1016/j.ciresp.2017.01.007. Epub 2017 Mar 17.
Irreversible electroporation is a novel technique growing in popularity over the last years among the ablative modalities. Its unique action mechanism produces irreversible nanopores in the membrane of the cell leading to apoptosis; therefore irreversible electroporation can be used to ablate substantial volumes of tissue without the undesirable thermal effects as the "heat sink effect". Moreover the extracellular matrix is left unperturbed, thus sparing the structural architecture of surrounding structures such as bile ducts and blood vessels. In the last years its use has been widespread in both liver and pancreatic ablation. Irreversible electroporation has shown its safety with however some caution, feasibility and favorable outcomes in clinical settings such as unresectable locally advanced disease in which the surgical and therapeutic options are very limited.
不可逆电穿孔是一种近年来在消融技术中越来越受欢迎的新技术。其独特的作用机制会在细胞膜上产生不可逆的纳米孔，从而导致细胞凋亡；因此，不可逆电穿孔可用于消融大量组织，而不会产生如“热沉效应”等不良热效应。此外，细胞外基质不受干扰，从而保留了周围结构如胆管和血管的结构架构。近年来，它在肝脏和胰腺消融中都得到了广泛应用。不可逆电穿孔已显示出其安全性，但仍需一些谨慎操作，在临床环境中，如手术和治疗选择非常有限的不可切除局部晚期疾病中，它具有可行性和良好的效果。
