National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 76, West Yanta Road, Xi'an, 710061, China.
Regenerative Medicine and Surgery Engineering Research Center of Shaanxi Province, First Affiliated Hospital of Xi'an Jiaotong University, No. 76, West Yanta Road, Xi'an, 710061, China.
Surg Endosc. 2020 Feb;34(2):580-589. doi: 10.1007/s00464-019-06800-3. Epub 2019 Apr 22.
Irreversible electroporation (IRE) is an emerging tissue ablation technique, which is safe for sites where thermal-basis techniques are not suitable. The aim of this study is to evaluate the safety and efficacy of magnetic anchoring electrode (MAE)-assisted IRE for normal gastric tissue ablation in a rabbit model.
IRE (500 V, 100 μs, 99 pulses, 1 Hz) of the gastric wall was performed in 24 adult New Zealand rabbits with a novel catheter-mounted MAE with fluoroscopy and a surgical approach. Procedure time, procedure-related bleeding, perforation, and other complications were recorded. Animals were sacrificed at 30 min, 1 day, 3 days, 7 days, 14 days, and 28 days post-IRE. The stomach was removed en bloc, and the diameter of each lesion was measured. Histopathological analyses by Hematoxylin-Eosin (H&E), masson trichrome, alpha-smooth muscle action (α-SMA), and terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) were performed.
Gastric tissue ablation with MAE-assisted IRE was successfully performed without any interruption. No perforation or bleeding was observed during IRE or throughout the follow-up period. A demarcated hemorrhage was found in the ablated area upon gross examination. H&E staining showed complete cell death with inflammatory infiltration, edema, and hemorrhaging. TUNEL presented diffuse positive cells in the ablated area. The tissue scaffold was well preserved without damage as indicated by Masson trichrome staining. Ulceration was observed starting from 3 days post-IRE. The mucosal layer was gradually recovered and regenerated within 14-28 days. No other complication was observed post-IRE.
MAE-assisted IRE is safe and effective for normal gastric tissue ablation and the gastric wall recovered in 14-28 days post-IRE.
不可逆电穿孔（IRE）是一种新兴的组织消融技术，对于不适合热疗的部位是安全的。本研究旨在评估新型导管式磁锚定电极（MAE）辅助 IRE 对兔正常胃组织消融的安全性和有效性。
在透视和手术入路下，使用新型导管式 MAE 对 24 只成年新西兰兔的胃壁进行 IRE（500V，100μs，99 个脉冲，1Hz）。记录操作时间、与操作相关的出血、穿孔和其他并发症。IRE 后 30 分钟、1 天、3 天、7 天、14 天和 28 天处死动物。整块胃被切除，测量每个病变的直径。通过苏木精-伊红（H&E）、Masson 三色、α-平滑肌肌动蛋白（α-SMA）和末端脱氧核苷酸转移酶介导的缺口末端标记（TUNEL）进行组织病理学分析。
MAE 辅助 IRE 成功地进行了胃组织消融，没有任何中断。IRE 过程中或整个随访过程中均未观察到穿孔或出血。大体检查发现消融区域有明显的出血。H&E 染色显示完全的细胞死亡伴有炎症浸润、水肿和出血。TUNEL 显示在消融区域有弥漫性阳性细胞。Masson 三色染色显示组织支架保存完好，无损伤。IRE 后 3 天开始出现溃疡。黏膜层在 14-28 天内逐渐恢复和再生。IRE 后无其他并发症。
MAE 辅助 IRE 对正常胃组织消融是安全有效的，胃壁在 IRE 后 14-28 天内恢复。
