Impact of Ultrasound-Guided Acetic Acid Hypertonic Saline Solution Injection on Radiofrequency Ablation Destructive Zone in Dog Liver_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Hai ¹ , MA Kuansheng ¹ , ZHANG Fengshen ² , LI Tingjun ¹ , OU Xia ¹ , WANG Shuguang ¹

Institute of Hepatobiliary Surgery ＆ Southwest Hospital, The Third Military Medical University, Chongqing 400038, China;

Corresponding author：

Keywords：

Radiofrequency ablation; Acetic acid; Hypertonic saline solution; Destructive zone

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To investigate the impact of injection of acetic acid hypertonic saline solution (AHS) in dog liver during radiofrequency ablation (RFA) on its destructive zone.
Methods 　RFAs were performed in dog livers by using LDRF-120S mutiple probe ablation system combining 50% acetic acid 5% hypertonic saline solution injection. Thirty healthy adult hybrid dogs were randomly divided into 5 groups (n=6). Group A: RFA was performed immediately after injection of 2 ml AHS; Group B: RFA was performed 5 min after injection of 2 ml AHS; Group C: RFA was performed immediately after injection of 4 ml AHS; Group D: RFA was performed 5 min after injection of 4 ml AHS; Group E: RFA was performed immediately after injection of 6 ml AHS.
Results 　There were no significant differences in the mean initial impedance within 5 groups. The mean ablation times were different significantly among 5 groups (F=83.831, P＜0.001). The mean ablation time was different significantly between any two groups by LSD-t analysis (P＜0.001).
The mean coagulation diameters were different significantly among 5 groups （F=53.488, P＜0.001）. The mean coagulation diameter of group E was the largest among 5 groups. Besides mean coagulation diameter was no significant difference between group D and E (P gt;0.05), the mean coagulation diameter was different significantly between any two groups by LSD-t analysis (P＜0.001). Obviously thrombus were shown in coagulation necrosis zone and nearly normal tissue with gordon amp; sweet. AHS spillage from the injection site occurred in group E. Four dogs died in group E within 14 d but no dog died in the other groups.
Conclusion 　RFA is performed 5 min after injection of 4 ml AHS in dog liver produces the ideal ablation destructive zone.

Citation： SUN Hai,MA Kuansheng,ZHANG Fengshen,LI Tingjun,OU Xia,WANG Shuguang. Impact of Ultrasound-Guided Acetic Acid Hypertonic Saline Solution Injection on Radiofrequency Ablation Destructive Zone in Dog Liver. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(5): 547-550. doi: Copy

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13.	张盟辉，孔宪炳，王巧玲，等. 射频消融联合亚砷酸局部治疗对兔肝VX2肿瘤MVD和VEGF表达的影响 [Ｊ]. 中国普外基础与临床杂志， 2007； 14（1）∶ 19.
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16.	Ahmed M, Weinstein J, Liu ZJ, et al. Image-guided percutaneous chemical and radiofrequency tumor ablation in an animal model [Ｊ]. J Vasc Interv Radiol, 2003； 14(8)∶ 1045.
17.	Kurokohchi K, Watanabe S, Masaki, et al. Comparison between combination therapy of percutaneous ethanol and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma [Ｊ]. World J Gastroenterol, 2005； 11(10)∶ 1426.
18.	Ahmed M, Monsky WE, Girnum G, et al. Radiofrequency thermal ablation sharply increases intratumoral liposomal doxorubicin accumulation and tumor coagulation [Ｊ]. Cancer Res, 2003； 63(19)∶ 6327.
19.	任正刚. 原发性肝癌的射频毁损治疗的进展 [Ｊ]. 中国普外基础与临床杂志， 2007； 14（1）∶ 5.
20.	Tamai T, Seki T, Imamura M, et al. Development of local necrosis, side-effects and histopathological study after hepatic injection of acetic acid solutions [Ｊ]. International Hepatology Communications, 1997； 6(3)∶ 153.
21.	Liang HL, Yang CF, Pan HB, et al. Small hepatocellular carcinoma: safety and efficacy of single high-dose percutaneous acetic acid injection for treatment [Ｊ]. Radiology, 2000； 214(3)∶ 769.

1. 　张志坚. 肝癌的射频消融治疗 [Ｊ]. 中华实用外科学杂志，2004； 24(8)∶ 465.
2. 　范林军，马宽生，何振平, 等. 射频消融治疗大肝癌的安全性和近期疗效 [Ｊ]. 中国普外基础与临床杂志， 2002； 9（4）∶ 265.
3. 　陈利平，李宁. 肝癌的射频治疗 [Ｊ]. 中国普外基础与临床杂志， 2006； 13（4）∶ 482.
4. 　Frieser M, Haensler J, Schaber S, et al. Radiofrequency ablation of liver tumors: how to enlarge the necrotic zones? [Ｊ]. Eur Surg Res, 2004； 36(6)∶ 357.
5. 　Lee JM, Kim YK, Kim SW, et al. Combined radiofrequency ablation and acetic acid hypertonic saline solution instillation: an in vivo study of rabbit liver [Ｊ]. Korean J Radiol, 2004； 5(1)∶ 31.
6. 　马宽生. 肝癌的局部消融治疗及进展 [Ｊ]. 肝胆外科杂志, 2005； 13(4)∶ 250.
7. 　严昆, 王艳滨, 陈敏华，等. 172例肝癌射频消融治疗预后因素分析 [Ｊ]. 中华医学杂志, 2005； 85(33)∶ 2322.
8. 　Lee JM, Kim SH, Han JK, et al. Ex vivo experiment of saline-enhanced hepatic bipolar radiofrequency ablation with a perfused needle electrode: comparison with conventional monopolar and simultaneous monopolar modes [Ｊ]. Cardiovasc Intervent Radiol, 2005； 28（3）∶ 338.
9. 　马宽生，陈敏，黄小兰，等. 一次定位多点穿刺法在射频消融治疗肝癌中的应用 [Ｊ]. 中华肝胆外科杂志, 2003； 9(4)∶ 199.
10. 　Kim SK, Rhim H, Kim YS, et al. Radiofrequency thermal ablation of hepatic tumors: pitfalls and challenges [Ｊ]. Abdom Imaging, 2005； 30(6)∶ 727.
11. 　Goldberg SN, Saldinger PF, Gazelle GS, et al. Percutaneous tumor ablation: increased necrosis with combined radio-frequency ablation and intratumoral doxorubicin injection in a rat breast tumor model [Ｊ]. Radiology， 2001； 220(2)∶ 420.
12. 　Lee JM, Kim YK, Kim SW, et al. Combined treatment of radiofrequency ablation and acetic acid injection: an in vivo feasibility study in rabbit liver [Ｊ]. Eur Radiol， 2004; 14(7)∶ 1303.
13. 　张盟辉，孔宪炳，王巧玲，等. 射频消融联合亚砷酸局部治疗对兔肝VX2肿瘤MVD和VEGF表达的影响 [Ｊ]. 中国普外基础与临床杂志， 2007； 14（1）∶ 19.
14. 　Lubienski A, Du M, Lubienski K, et al. Radiofrequency thermal ablation: increase in lesion diameter with continuous acetic acid infusion [Ｊ]. Cardiovasc Intervent Radiol, 2005； 28(6)∶789.
15. 　Burdío F, Güemes A, Burdío JM, et al. Large hepatic ablation with bipolar saline-enhanced radiofrequency: an experimental study in in vivo porcine liver with a novel approach [Ｊ]. J Surg Res, 2003； 110(1)∶ 193.
16. 　Ahmed M, Weinstein J, Liu ZJ, et al. Image-guided percutaneous chemical and radiofrequency tumor ablation in an animal model [Ｊ]. J Vasc Interv Radiol, 2003； 14(8)∶ 1045.
17. 　Kurokohchi K, Watanabe S, Masaki, et al. Comparison between combination therapy of percutaneous ethanol and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma [Ｊ]. World J Gastroenterol, 2005； 11(10)∶ 1426.
18. 　Ahmed M, Monsky WE, Girnum G, et al. Radiofrequency thermal ablation sharply increases intratumoral liposomal doxorubicin accumulation and tumor coagulation [Ｊ]. Cancer Res, 2003； 63(19)∶ 6327.
19. 　任正刚. 原发性肝癌的射频毁损治疗的进展 [Ｊ]. 中国普外基础与临床杂志， 2007； 14（1）∶ 5.
20. 　Tamai T, Seki T, Imamura M, et al. Development of local necrosis, side-effects and histopathological study after hepatic injection of acetic acid solutions [Ｊ]. International Hepatology Communications, 1997； 6(3)∶ 153.
21. 　Liang HL, Yang CF, Pan HB, et al. Small hepatocellular carcinoma: safety and efficacy of single high-dose percutaneous acetic acid injection for treatment [Ｊ]. Radiology, 2000； 214(3)∶ 769.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Impact of Ultrasound-Guided Acetic Acid Hypertonic Saline Solution Injection on Radiofrequency Ablation Destructive Zone in Dog Liver

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