How I Do It: Intraoperative use of radiofrequency treatment allows an increase in the rate of curative liver resection

Élias, Dominique; Debaere, Thierry; Muttillo, Irnerio Angelo; Cavalcanti, A.; Coyle, Catherine; Roche, Alain

doi:10.1002/(sici)1096-9098(199803)67:3<190::aid-jso9>3.0.co;2-4

Cited by 100 publications

(27 citation statements)

References 2 publications

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“…The other way to increase the size of the lesions in the liver is to decrease the heat dispersion induced by the liver perfusion which has been investigated in experimental studies in RF and in laser liver ablation and in laser ablation technique [9,10,11,12,16,17]. From these experimental studies, lesion surface was increased when occlusion maneuvers were used, but the respective role of each technique could not be defined.…”

Section: Discussionmentioning

confidence: 99%

“…We investigated the biliary and portal complications that may appear when we combine vascular occlusion and RF. Biliary or portal complications have never been described in clinical series or in experimental studies with RF [8,15,16,22,23,24]; however, clinical series rarely used vascular occlusions. In previously reported experimental studies animals were killed immediately after combining RF lesions and vascular occlusion and probably biliary complications could not be observed in this situation.…”

Section: Discussionmentioning

confidence: 99%

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Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig model

et al. 2001

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The aim of this study was to assess the effect of vascular occlusion on radio-frequency (RF) lesion size and on potential associated biliary and portal lesions. Radio-frequency lesions using a 1-cm exposed-tip cooled electrode were created in pig liver. Liver perfusion was modified by arterial embolization (n=2), left portal clamping (n=2), and both (n=2). Two pigs were used as controls. Two weeks after, control portography was performed, animals were killed, and ex-vivo cholangiography was carried out. Pathological studies evaluated the lesion surface and associated portal and biliary damages. A mathematical regression model showed that portal occlusion increased by 43 mm2 (+40%) the surface of RF lesions, arterial occlusion by 135 mm2 (+126%), and associated occlusion by 466 mm2 (+435%). Biliary stenoses were found in 4 cases (two arterial occlusions, one portal occlusion, and one associated occlusion). One case of partial portal vein thrombosis was found in one case of portal occlusion and resolved at 2 weeks. Ischemic damages adjacent to RF lesions were found in cases of combined occlusions. The reduction of liver perfusion increases significantly the size of RF lesions but is associated with a risk of biliary, portal, or parenchymal complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig model

et al. 2001

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“…The surgeon constantly referred to drawing indicating the sites and sizes of LM produced following ultrasound detection before RFA. Simple RFA sessions were performed (14), but when necessary, the central bile ducts were also cooled to protect them from heat (a technique we described in 2001) (15,16), or a trans-RF hepatectomy was performed after RF destruction of one or several LM located along a suitable transection line, in order to spare as much normal parenchyma as possible (a technique we described in 2002) (17,18). Patients underwent a postoperative CTscan before being discharged from hospital.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Combined liver surgery and RFA for patients with gastroenteropancreatic endocrine tumors presenting with more than 15 metastases to the liver

Élias

Goèré

Leroux

et al. 2009

European Journal of Surgical Oncology (EJSO)

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Please cite this article as: Elias D., Goéré D., Leroux G., Dromain C., Leboulleux S., de Baere T., Ducreux M., Baudin E. Combined liver surgery and RFA for patients with gastroenteropancreatic endocrine tumors presenting with more than 15 metastases to the liver., European Journal of Surgical Oncology (2009Oncology ( ), doi: 10.1016Oncology ( /j.ejso.2009 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Accepted ManuscriptTitle: Combined liver surgery and RFA for patients with gastroenteropancreatic endocrine tumors presenting with more than 15 metastases to the liver.

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“…These include the use of monoprobes such as elongated [14], internally cooled [5,6] and saline-enhanced [7,8] electrodes, and multiprobes such as array [15], bipolar [4], clustered-cooled [10], and expandable electrodes [9]. Among these newly designed probes, the expandable electrode, which features a monopolar approach but multipolar function, has already been accepted in many centers for clinical use [9,17,21,24,25]. However, even with this electrode the created ablation volume is thus far still not large enough to encompass both the entire tumor and a peritumoral safety margin of additional 0.5±1 cm in many clinical situations.…”

Section: Introductionmentioning

confidence: 99%

An ex vivo study on radiofrequency tissue ablation: increased lesion size by using an "expandable-wet" electrode

Miao

et al. 2001

Eur Radiol

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The present comparative study was conducted to validate a newly developed "expandable-wet" electrode for an increased lesion size of radiofrequency ablation (RFA) on excised beef liver. The expandable-wet electrode, which allows interstitial hypertonic saline infusion through retractable curved needles, was compared with "expanded-dry" and "unexpanded-wet" electrodes for RFA lesion size and other parameters. A total of 120 lesions were created under 50 W (groups A-C) and 90 W (groups A'-C') power control mode for 10 min at each ablation site with the following groups: group A and A' of expanded-dry electrode (needles deployed but saline uninfused); group B and B' of unexpanded-wet electrode (saline infused but needle undeployed); and group C and C' of expanded-wet electrode (needles deployed and saline infused). Together with lower impedance and higher power output, the lesion size in group C (5.3+/-0.4 cm) and C' (6.0+/-1.0 cm) were significantly larger (P<0.01) than that in group A (3.3+/-0.3 cm) and A' (2.0+/-0.2 cm), and group B (3.8+/-1.0 cm) and B' (2.6+/-0.4 cm). The RFA lesion size can be significantly enlarged when the expandable electrode is complemented with interstitial hypertonic saline infusion. This design may improve the efficacy of RF tumor ablation.

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How I Do It: Intraoperative use of radiofrequency treatment allows an increase in the rate of curative liver resection

Cited by 100 publications

References 2 publications

Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig model

Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig model

Combined liver surgery and RFA for patients with gastroenteropancreatic endocrine tumors presenting with more than 15 metastases to the liver

An ex vivo study on radiofrequency tissue ablation: increased lesion size by using an "expandable-wet" electrode

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