使用新型柔性支气管镜冷冻探针对离体猪肺和肝的周围肺部病变进行冷冻消融。

The Cryoablation for Peripheral Pulmonary Lesions Using a Novel Flexible Bronchoscopic Cryoprobe in the ex vivo Pig Lung and Liver.

机构信息

Department of Endoscopy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Respiration. 2019;97(5):457-462. doi: 10.1159/000494142. Epub 2019 Feb 21.

DOI:10.1159/000494142

PMID:30799405

Abstract

BACKGROUND

Percutaneous cryoablation has been used for the treatment of lung cancer and has been shown to be safe and effective. However, some lung cancer lesions cannot be reached by percutaneous puncture; using bronchoscopy cryoablation is necessary in these cases.

PURPOSES

To examine the efficiency and security of a flexible cryoprobe, we measured the size and temperature distribution of the frozen area (ice ball) in ex vivo pig lung and liver and the temperature of the bronchoscope.

METHODS

We evaluated flexible cryoprobe cryoablation using a bronchoscope in ex vivo pig lung and a flexible cryoprobe alone in ex vivo pig liver. Seven temperature sensors were positioned at the surface of the cryoprobe and at distances of 0.3, 0.6, 0.9, 1.2, 1.5, and 1.8 cm from the cryoprobe. Two temperature sensors were positioned at the surface of the bronchoscope. The ex vivo pig lung and liver were perfused with 37°C saline and the former was inflated using a ventilator to simulate in vivo lung conditions. The whole operation is usually 2-3 freezing cycles.

RESULTS

In ex vivo pig liver, probes made ice balls of 33.2 ± 0.2 mm in diameter. In ex vivo pig lung, probes made ice balls of 35.1 ± 1.7 mm in diameter. The temperature at the surface of the bronchoscope at distances of 1 and 10 cm from the cryoprobe reached 21.1 ± 0.1 and 10.5 ± 0.2°C.

CONCLUSION

A flexible cryoprobe using a bronchoscope in ex vivo pig lung and liver was a sufficiently safe treatment method.

摘要

背景

经皮冷冻消融已被用于治疗肺癌，且已被证实是安全有效的。然而，一些肺癌病灶无法通过经皮穿刺到达；在这种情况下，需要使用支气管镜冷冻消融。

目的

为了检查一种柔性冷冻探针的效率和安全性，我们测量了离体猪肺和肝中冷冻区域（冰球）的大小和温度分布以及支气管镜的温度。

方法

我们在离体猪肺中使用支气管镜评估了柔性冷冻探针冷冻消融，以及单独使用柔性冷冻探针在离体猪肝中的应用。在冷冻探针表面和距离冷冻探针 0.3、0.6、0.9、1.2、1.5 和 1.8 厘米处的位置共放置了 7 个温度传感器。在支气管镜表面放置了 2 个温度传感器。离体猪肺和肝用 37°C 生理盐水灌注，前者使用呼吸机充气以模拟体内肺的情况。整个操作通常需要 2-3 个冷冻循环。