Thermal ablation of pancreatic cyst with a prototype endoscopic ultrasound capable radiofrequency needle device: A pilot feasibility study
| Autor: | Abdurrahman Kadayifci, Maria Moris, Michael B. Wallace, Mustafa Atar, William R. Brugge, Murli Krishna, Ariston L. Librero, Eugene Richie |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Endoscopic ultrasound
medicine.medical_specialty medicine.medical_treatment Ablation 03 medical and health sciences 0302 clinical medicine needle Submucosa medicine Radiology Nuclear Medicine and imaging Cyst pancreas cyst Hepatology medicine.diagnostic_test business.industry Gastroenterology medicine.disease medicine.anatomical_structure Fine-needle aspiration 030220 oncology & carcinogenesis Pancreatectomy 030211 gastroenterology & hepatology Original Article Radiology Pancreatic cysts prototype Nuclear medicine business Pancreas |
| Zdroj: | Endoscopic Ultrasound |
| ISSN: | 2226-7190 2303-9027 |
| Popis: | Background and Objectives: Pancreatic cysts are evaluated by endoscopic ultrasound and fine needle aspiration (EUS). The only accepted treatment is pancreatectomy, which is associated with morbidity and mortality. This study evaluated the optimal thermal dosimetry of a novel radiofrequency ablation device using a standard electrosurgical unit in ex vivo cyst models. Methods: A modified EUS 22-gauge monopolar needle prototype with a tip electrode connected to a standard electrosurgical unit (Erbe USA, Marietta, GA, USA) was used to induce a subboiling point temperature. A cyst model was created using 2-cm sections of porcine small intestine ligated and filled with saline. After ablation, the cyst models were prepared for pathological evaluation. The epithelial layers were measured in at least two different sites with a micrometer and compared with the corresponding control sample. Results: Thirty-two cyst models were ablated with maximum temperatures of 50°C, 60°C, 90°C, and 97°C in 8, 11, 11, and 2 cysts, respectively. Longer ablation times were required to induce higher temperatures. A trend in the reduction in thickness of the measured layers was observed after exposure to higher temperatures. A temperature over 50°C was required for the ablation of the muscularis, submucosa, and villi, and over 60°C was required to ablate the mucosal crypts. Conclusions: In a preclinical model, a novel radiofrequency EUS-capable needle connected to a standard electrosurgical unit using standard low-voltage coagulation provided ablation in a temperature-dependent fashion with a threshold of at least 60°C and a safe cyst margin below 97°C. This potentially will allow low-cost, convenient cyst ablation. |
| Databáze: | OpenAIRE |
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