College of Medicine, Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan.
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Int J Hyperthermia. 2021;38(1):357-362. doi: 10.1080/02656736.2021.1892215.
Radiofrequency (RF)-assisted devices are widely used for hemostasis during liver resection. This study compared the use of dual switching (DS) versus single switching (SS) control modes for RF-based liver resections in a pig model.
The RF-based system comprised a 200-W generator and three electrodes with 4-cm tips arranged in a linear configuration using an adaptor. Eight Lanyu pigs were used to assess ablation outcomes with electrode spacing of 2 or 3 cm, and ablation durations of 1.5, 2 or 3 min. All combinations were tested in DS and SS modes. Procedures were performed on left lateral, caudal and right anterior liver lobes, and after which transections were performed using a scalpel. Blood loss, complete ablation rate and ablation speed were compared.
DS mode was shown to induce significantly less blood loss than SS mode when the electrode spacing was set at 2 cm and the ablation duration was 2 min or 3 min (=.010 and .012, respectively). Extended ablation duration and narrow electrode spacing tended to induce less blood loss, regardless of operating mode. Bloodless resection was achieved using DS mode with electrode spacing of 2 cm and ablation duration of 2-3 min. The highest rate of complete ablation (11.3 cm/min) was achieved using DS mode with electrode spacing of 2 cm and ablation duration of 1.5 min.
RF-based hepatic resection using DS mode is safe and feasible, resulting in less blood loss than SS mode with a higher rate of complete ablation (i.e., superior ablation efficiency).
射频（RF）辅助设备广泛用于肝切除术中的止血。本研究比较了双切换（DS）与单切换（SS）控制模式在猪模型中用于基于 RF 的肝切除的效果。
基于 RF 的系统由 200-W 发生器和三个带有 4-cm 尖端的电极组成，电极以线性配置排列，并使用适配器将其连接。使用 Lanyu 猪来评估电极间距为 2 或 3cm 以及消融时间为 1.5、2 或 3min 时的消融效果。在 DS 和 SS 模式下测试所有组合。在左外侧、尾状叶和右前叶进行手术，然后使用手术刀进行横断。比较出血量、完全消融率和消融速度。
当电极间距为 2cm 且消融时间为 2 或 3min 时，DS 模式比 SS 模式导致的出血量显著减少（分别为.010 和.012）。无论操作模式如何，延长消融时间和缩小电极间距都会导致出血量减少。使用 DS 模式和电极间距为 2cm、消融时间为 2-3min 可实现无血切除。使用 DS 模式和电极间距为 2cm、消融时间为 1.5min 可达到最高的完全消融率（11.3cm/min）。
使用 DS 模式进行基于 RF 的肝切除术是安全可行的，与 SS 模式相比，其出血量较少，且完全消融率较高（即消融效率更高）。
