Laparoscopic and computed tomography-guided percutaneous radiofrequency ablation of renal tissue: acute and chronic effects in an animal model
| Autor: | Jay T. Bishoff, Alan J Iverson, Mark P. Burton, Jim D Crowley, Jack B. Shelton, Neal C. Dalrymple |
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| Rok vydání: | 2001 |
| Předmět: |
medicine.medical_specialty
Percutaneous Swine Radiofrequency ablation Urology medicine.medical_treatment Kidney Adipose capsule of kidney law.invention Lesion law Monitoring Intraoperative medicine Animals Hematoma medicine.diagnostic_test business.industry medicine.disease Ablation Urinoma Nephrectomy Endoscopy surgical procedures operative Catheter Ablation Feasibility Studies Kidney Cortex Necrosis Kidney Diseases Laparoscopy Radiology medicine.symptom Tomography X-Ray Computed business therapeutics |
| Zdroj: | Urology. 57:976-980 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/s0090-4295(00)01129-8 |
| Popis: | Objectives. To evaluate the laparoscopic and percutaneous delivery of impedance-based radiofrequency ablation (RFA) of the kidney by studying the acute and chronic clinical, radiographic, and histopathologic effects in the porcine model. Methods. Eight kidneys from 4 pigs underwent laparoscopic RFA. Six kidneys from 3 additional pigs received computed tomography (CT)-guided, percutaneous RFA. CT scans were performed immediately after RFA and before harvest at 2 hours, 24 hours, 3 weeks, and 13 weeks. The gross, radiographic, and histopathologic changes were recorded for each period. Results. Grossly, the RFA lesions were sharply demarcated, measuring 3 to 5 cm. Two major complications (14%) occurred (one urinoma, one psoas muscle injury) in 14 ablations. No deaths or significant blood loss occurred as a result of RFA. Radiographically, the immediate CT scanning demonstrated small perinephric hematomas and wedge-shaped defects. Delayed CT showed nonenhancing defects up to 5 cm. Color-flow and power Doppler were unable to distinguish significant tissue changes during RFA. The histopathologic evaluation revealed marked inflammation surrounding the necrotic regions in the early lesions; chronic lesions were characterized by dense fibrosis. The tissue temperatures ranged from 62° to 118°C in the area of ablation. Conclusions. RFA is readily delivered laparoscopically or percutaneously with minimal morbidity. Impedance-based application of radiofrequency energy allows monitoring and control of ablation. Using a multi-antenna probe, areas of tissue up to 5 cm can be completely destroyed. The RFA lesion can be monitored as a nonenhancing cortical defect on CT. |
| Databáze: | OpenAIRE |
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