Safety Limit of Large-Volume Hepatic Radiofrequency Ablation in a Rat Model

Abstract

Background: Large-volume hepatic radiofrequency ablation (RFA) has been used to treat large liver tumors, but its safety limit is unknown. This study aimed to investigate the possible systemic responses of largevolume hepatic RFA and to estimate its safety limit in normal and cirrhotic rats. Hypothesis: Large-volume hepatic RFA causes a significant systemic inflammatory reaction.

Bacterial Translocation in a Rat Model of Large Volume Hepatic Radiofrequency Ablation

“…However, the number of sessions applied and hence the total ablated volume have been considered as risk factors for the occurrence of post-RFA complications [3,6]. Extensive liver RFA has been studied in rat and pig models by ablation of liver volumes ranging from 30% to 60% of total liver volume [25][26][27]. In our study, the ablated liver mass was around 28.5%, constituting a model for the study of large-volume hepatic RFA.…”

Oxidative and pre-inflammatory stress in wedge resection of pulmonary parenchyma using the radiofrequency ablation technique in a swine model

“…Its increase in the RFA group can be explained by the significant cell destruction created by the thermal injury, corresponding to a larger extend of pulmonary tissue necrosis at both sides of the cut edge compared to the "cut and sew" method of the control group. Whether simultaneous destruction of the microcirculation in RFA lung resection could represent a restriction barrier for propagation of the regional oxidative stress to the systemic circulation needs further investigation [10]. …”

“…However the local and systemic results of RFA lung resection need further investigation as lung tissue damage and coagulative necrosis created as a result of RFA thawing process can probably act as a source of toxic substances that can further induce a systemic inflammatory reaction. This has been shown in animal studies whereas RFA-assisted resection of more than 40% of the liver caused significant systemic inflammatory responses and led to poor survival [10]. …”

Large Volume Hepatic Microwave Ablation Elicits Fewer Pulmonary Changes than Radiofrequency or Cryotherapy

“…4 Interestingly, systemic responses similar to those obtained from CRYO following ablation of 35% of the volume of normal liver occurred when 50-60% of the normal liver parenchyma were ablated with RFA. 11,12 These results suggest that hepatic tumour ablation that results from RFA-induced thermal coagulation produces a much lower systemic inflammatory insult than an equivalent ablation produced by cryotherapy. 12 As far as we are aware, there are no studies to date which have investigated the pulmonary consequences of hepatic ablation by microwave ablation (MTA) which is the most recent technology to be investigated and which is increasingly popular.…”