Rombouts Steffi J E, van Dijck Willemijn P M, Nijkamp Maarten W, Derksen Tyche C, Brosens Lodewijk A A, Hoogwater Frederik J H, van Leeuwen Maarten S, Borel Rinkes Inne H M, van Hillegersberg Richard, Wittkampf Fred H, Molenaar Izaak Q
Department of Surgery, University Medical Center Utrecht Cancer Center, Heidelberglaan 100, 3508 GA, P.O. Box 85500, Utrecht, The Netherlands.
Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, P.O. Box 85500, Utrecht, The Netherlands.
HPB (Oxford). 2017 Dec;19(12):1058-1065. doi: 10.1016/j.hpb.2017.02.443. Epub 2017 Oct 10.
Irreversible electroporation (IRE) by inserting needles around the tumor as treatment for locally advanced pancreatic cancer entails several disadvantages, such as incomplete ablation due to field inhomogeneity, technical difficulties in needle placement and a risk of pancreatic fistula development. This experimental study evaluates outcomes of IRE using paddles in a porcine model.
Six healthy pigs underwent laparotomy and were treated with 2 separate ablations (in head and tail of the pancreas). Follow-up consisted of clinical and laboratory parameters and contrast-enhanced computed tomography (ceCT) imaging. After 2 weeks, pancreatoduodenectomy was performed for histology and the pigs were terminated.
All animals survived 14 days. None of the animals developed signs of infection or significant abdominal distention. Serum amylase and lipase peaked at day 1 postoperatively in all pigs, but normalized without signs of pancreatitis. On ceCT-imaging the ablation zone was visible as an ill-defined, hypodense lesion. No abscesses, cysts or ascites were seen. Histology showed a homogenous fibrotic lesion in all pigs.
IRE ablation of healthy porcine pancreatic tissue using two plate electrodes is feasible and safe and creates a homogeneous fibrotic lesion. IRE-paddles should be tested on pancreatic adenocarcinoma to determine the effect in cancer tissue.
通过在肿瘤周围插入针进行不可逆电穿孔（IRE）治疗局部晚期胰腺癌存在诸多缺点，如由于电场不均匀导致消融不完全、针放置的技术困难以及发生胰瘘的风险。本实验研究评估在猪模型中使用极板进行IRE的结果。
六只健康猪接受剖腹手术，并接受两次单独的消融治疗（分别在胰头和胰尾）。随访包括临床和实验室参数以及对比增强计算机断层扫描（ceCT）成像。两周后，进行胰十二指肠切除术以获取组织学样本，然后处死猪。
所有动物均存活14天。没有动物出现感染迹象或明显腹胀。所有猪的血清淀粉酶和脂肪酶在术后第1天达到峰值，但随后恢复正常，且无胰腺炎迹象。在ceCT成像上，消融区表现为边界不清的低密度病变。未见脓肿、囊肿或腹水。组织学显示所有猪均有均匀的纤维化病变。
使用两个平板电极对健康猪胰腺组织进行IRE消融是可行且安全的，并产生均匀的纤维化病变。IRE极板应在胰腺腺癌上进行测试，以确定对癌组织的效果。
