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Article: Safety limit of large-volume hepatic radiofrequency ablation in a rat model

TitleSafety limit of large-volume hepatic radiofrequency ablation in a rat model
Authors
Issue Date2006
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 2006, v. 141 n. 3, p. 252-258 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/83921
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorNg, KKen_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorPoon, RTen_HK
dc.contributor.authorShek, TWen_HK
dc.contributor.authorHo, DWen_HK
dc.contributor.authorFan, STen_HK
dc.date.accessioned2010-09-06T08:46:48Z-
dc.date.available2010-09-06T08:46:48Z-
dc.date.issued2006en_HK
dc.identifier.citationArchives Of Surgery, 2006, v. 141 n. 3, p. 252-258en_HK
dc.identifier.issn0004-0010en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83921-
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.en_HK
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_HK
dc.relation.ispartofArchives of Surgeryen_HK
dc.titleSafety limit of large-volume hepatic radiofrequency ablation in a rat modelen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0004-0010&volume=141&issue=3&spage=252&epage=258&date=2006&atitle=Safety+limit+of+large-volume+hepatic+radiofrequency+ablation+in+a+rat+modelen_HK
dc.identifier.emailPoon, RT: poontp@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityPoon, RT=rp00446en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1001/archsurg.141.3.252en_HK
dc.identifier.pmid16549690en_HK
dc.identifier.scopuseid_2-s2.0-33645102297en_HK
dc.identifier.hkuros116878en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33645102297&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume141en_HK
dc.identifier.issue3en_HK
dc.identifier.spage252en_HK
dc.identifier.epage258en_HK
dc.identifier.isiWOS:000235844800005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridNg, KK=7403179075en_HK
dc.identifier.scopusauthoridLam, CM=7402989820en_HK
dc.identifier.scopusauthoridPoon, RT=7103097223en_HK
dc.identifier.scopusauthoridShek, TW=7005479861en_HK
dc.identifier.scopusauthoridHo, DW=7402971906en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK

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