Goldwasser B, Ramon J, Engelberg S, Ohad D, Sharkey H, Strul B, Rasor J S, Edwards S D
Department of Urology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Eur Urol. 1993;24(3):400-5. doi: 10.1159/000474337.
Transurethral needle ablation of the canine prostate using low level radiofrequency energy was examined for efficacy and safety in a two-stage experimental study. Eleven mongrel dogs were treated via the bladder neck and prostatic urethra using a specially designed catheter through which needle antennas were advanced into the prostatic tissue. A radiofrequency energy source was connected to the catheter and used to create tissue ablation. In the first 5 dogs this was found to be feasible. Necrotic lesions were created around the needle antennas. Typically, lesions were 1 cm in diameter and conical in shape. The actual size of the lesion was directly related to power level used, time of ablation and length of needle deployment. In the next 6 dogs temperatures were simultaneously measured in the prostatic urethra and rectum. The dogs were sacrificed 0, 2, 2, 14, 28 and 30 days following the experiments and the bladder, prostate and anterior rectal wall were removed en bloc and examined macroscopically and histopathologically for any changes. It was found that urethral temperatures increased to 46.1 degrees C on the average while rectal temperature did not rise during the entire experiment. The lesions found in the prostate were similar to those found in the first 5 dogs. No macroscopic or histopathologic changes were noted at the bladder base, anterior rectal wall or in the distal prostatic urethra. It was concluded that prostatic tissue ablation in the canine model can be achieved safely and could justify the start of human trials.
在一项分两阶段的实验研究中,对使用低水平射频能量经尿道针状消融犬前列腺的有效性和安全性进行了检查。使用一种专门设计的导管,通过膀胱颈和前列腺尿道对11只杂种犬进行治疗,针状天线通过该导管推进到前列腺组织中。将射频能量源连接到导管上,用于产生组织消融。在前5只犬中,发现这是可行的。在针状天线周围形成了坏死灶。典型的病灶直径为1厘米,呈圆锥形。病灶的实际大小与所使用的功率水平、消融时间和针展开的长度直接相关。在接下来的6只犬中,同时测量前列腺尿道和直肠的温度。在实验后的0、2、2、14、28和30天处死这些犬,将膀胱、前列腺和直肠前壁整块切除,进行大体和组织病理学检查以观察任何变化。结果发现,在整个实验过程中,尿道温度平均升高到46.1摄氏度,而直肠温度没有升高。在前列腺中发现的病灶与在前5只犬中发现的相似。在膀胱底部、直肠前壁或前列腺尿道远端未发现大体或组织病理学变化。得出的结论是,在犬模型中可以安全地实现前列腺组织消融,这为开展人体试验提供了依据。