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Article: Safety limit of large-volume hepatic radiofrequency ablation in a rat model
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TitleSafety limit of large-volume hepatic radiofrequency ablation in a rat model
 
AuthorsNg, KK1
Lam, CM1
Poon, RT1
Shek, TW1
Ho, DW1
Fan, ST1
 
Issue Date2006
 
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
 
CitationArchives Of Surgery, 2006, v. 141 n. 3, p. 252-258 [How to Cite?]
DOI: http://dx.doi.org/10.1001/archsurg.141.3.252
 
AbstractBackground: 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 large-volume hepatic RFA and to estimate its safety limit in normal and cirrhotic rats. Hypothesis: Large-volume hepatic RFA causes a significant systemic inflammatory reaction. Design: Experimental study. Setting: University teaching hospital. Intervention: Using the Cool-tip RF System (Radionics, Burlington, Mass), RFA was performed for different percentages of the liver volume by weight in normal and cirrhotic Sprague-Dawley rats. Main Outcome Measures: Changes in concentrations of serum inflammatory markers (tumor necrosis factor α [TNF-α] and interleukin [IL] 6), functions of various end organs, and survival rates were assessed. Results: In the normal liver groups, the concentrations of TNF-α and IL-6 were significantly elevated in the early postoperative period when 50% (mean ± SD TNF-α concentration, 130.3 ± 15.6 pg/mL; mean ± SD IL-6 concentration, 163.2 ± 12.2 pg/mL) and 60% (mean ± SD TNF-α concentration, 145.7 ± 13.0 pg/mL; mean ± SD IL-6 concentration, 180.8 ± 11.0 pg/mL) of the liver volume were ablated compared with the control group (mean ± SD TNF-α concentration, 30.4 ± 9.9 pg/mL, P < .001; mean ± SD IL-6 concentration, 28.4 ± 6.7 pg/mL, P < .001). The concentrations of TNF-α and IL-6 in other groups remained similar to those in the control group. Thrombocytopenia, prolonged clotting time, and interstitial pneumonitis occurred when 50% and 60% of the liver volume were ablated. The 4-week survival rates were 100%, 60%, and 0% when 40%, 50%, and 60%, respectively, of the liver volume were ablated. Similar systemic inflammatory responses and poor survival rates were observed among the cirrhotic liver groups when 30% and 40% of the liver volume were ablated. Conclusions: The normal rats can tolerate RFA of 40% of the liver volume with minimal morbidity and no mortality whereas the cirrhotic rats can only tolerate 20% of the ablated liver volume. Beyond that limit, RFA would cause significant systemic inflammatory responses and poor survival. ©2006 American Medical Association. All rights reserved.
 
ISSN0004-0010
2013 Impact Factor: 4.297
 
DOIhttp://dx.doi.org/10.1001/archsurg.141.3.252
 
ISI Accession Number IDWOS:000235844800005
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorNg, KK
 
dc.contributor.authorLam, CM
 
dc.contributor.authorPoon, RT
 
dc.contributor.authorShek, TW
 
dc.contributor.authorHo, DW
 
dc.contributor.authorFan, ST
 
dc.date.accessioned2010-09-06T08:46:48Z
 
dc.date.available2010-09-06T08:46:48Z
 
dc.date.issued2006
 
dc.description.abstractBackground: 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 large-volume hepatic RFA and to estimate its safety limit in normal and cirrhotic rats. Hypothesis: Large-volume hepatic RFA causes a significant systemic inflammatory reaction. Design: Experimental study. Setting: University teaching hospital. Intervention: Using the Cool-tip RF System (Radionics, Burlington, Mass), RFA was performed for different percentages of the liver volume by weight in normal and cirrhotic Sprague-Dawley rats. Main Outcome Measures: Changes in concentrations of serum inflammatory markers (tumor necrosis factor α [TNF-α] and interleukin [IL] 6), functions of various end organs, and survival rates were assessed. Results: In the normal liver groups, the concentrations of TNF-α and IL-6 were significantly elevated in the early postoperative period when 50% (mean ± SD TNF-α concentration, 130.3 ± 15.6 pg/mL; mean ± SD IL-6 concentration, 163.2 ± 12.2 pg/mL) and 60% (mean ± SD TNF-α concentration, 145.7 ± 13.0 pg/mL; mean ± SD IL-6 concentration, 180.8 ± 11.0 pg/mL) of the liver volume were ablated compared with the control group (mean ± SD TNF-α concentration, 30.4 ± 9.9 pg/mL, P < .001; mean ± SD IL-6 concentration, 28.4 ± 6.7 pg/mL, P < .001). The concentrations of TNF-α and IL-6 in other groups remained similar to those in the control group. Thrombocytopenia, prolonged clotting time, and interstitial pneumonitis occurred when 50% and 60% of the liver volume were ablated. The 4-week survival rates were 100%, 60%, and 0% when 40%, 50%, and 60%, respectively, of the liver volume were ablated. Similar systemic inflammatory responses and poor survival rates were observed among the cirrhotic liver groups when 30% and 40% of the liver volume were ablated. Conclusions: The normal rats can tolerate RFA of 40% of the liver volume with minimal morbidity and no mortality whereas the cirrhotic rats can only tolerate 20% of the ablated liver volume. Beyond that limit, RFA would cause significant systemic inflammatory responses and poor survival. ©2006 American Medical Association. All rights reserved.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationArchives Of Surgery, 2006, v. 141 n. 3, p. 252-258 [How to Cite?]
DOI: http://dx.doi.org/10.1001/archsurg.141.3.252
 
dc.identifier.doihttp://dx.doi.org/10.1001/archsurg.141.3.252
 
dc.identifier.epage258
 
dc.identifier.hkuros116878
 
dc.identifier.isiWOS:000235844800005
 
dc.identifier.issn0004-0010
2013 Impact Factor: 4.297
 
dc.identifier.issue3
 
dc.identifier.openurl
 
dc.identifier.pmid16549690
 
dc.identifier.scopuseid_2-s2.0-33645102297
 
dc.identifier.spage252
 
dc.identifier.urihttp://hdl.handle.net/10722/83921
 
dc.identifier.volume141
 
dc.languageeng
 
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofArchives of Surgery
 
dc.relation.referencesReferences in Scopus
 
dc.titleSafety limit of large-volume hepatic radiofrequency ablation in a rat model
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong