1
|
Katsogiannou M, Amar-Millet A, Muller C, Desbriere R. Radiofrequency ablation of retained placenta accreta after conservative management. Eur J Obstet Gynecol Reprod Biol 2019; 240:383-384. [PMID: 31337515 DOI: 10.1016/j.ejogrb.2019.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/15/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Maria Katsogiannou
- Hôpital Saint Joseph, Department of Obstetrics and Gynecology, FR-13008, Marseille, France
| | - Annie Amar-Millet
- Hôpital Saint Joseph, Department of Anesthetics, FR-13008, Marseille, France
| | - Cyrille Muller
- Hôpital Saint Joseph, Department of Radiology, FR-13008, Marseille, France
| | - Raoul Desbriere
- Hôpital Saint Joseph, Department of Obstetrics and Gynecology, FR-13008, Marseille, France.
| |
Collapse
|
2
|
Ziegle J, Audigier C, Krug J, Ali G, Kim Y, Boctor EM, Friebe M. RF-ablation pattern shaping employing switching channels of dual bipolar needle electrodes: ex vivo results. Int J Comput Assist Radiol Surg 2018; 13:905-916. [DOI: 10.1007/s11548-018-1769-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/13/2018] [Indexed: 12/20/2022]
|
3
|
Chu KKW, Cheung TT. Update in management of hepatocellular carcinoma in Eastern population. World J Hepatol 2015; 7:1562-1571. [PMID: 26085915 PMCID: PMC4462694 DOI: 10.4254/wjh.v7.i11.1562] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 02/10/2015] [Accepted: 04/14/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the commonest malignant tumours in the East. Although the management of HCC in the West is mainly based on the Barcelona Clinic for Liver Cancer staging, it is considered too conservative by Asian countries where the number of HCC patients is huge. Scientific and clinical advances were made in aspects of diagnosis, staging, and treatment of HCC. HCC is well known to be associated with cirrhosis and the treatment of HCC must take into account the presence and stage of chronic liver disease. The major treatment modalities of HCC include: (1) surgical resection; (2) liver transplantation; (3) local ablation therapy; (4) transarterial locoregional treatment; and (5) systemic treatment. Among these, resection, liver transplantation and ablation therapy for small HCC are considered as curative treatment. Portal vein embolisation and the associating liver partition with portal vein ligation for staged hepatectomy may reduce dropout in patients with marginally resectable disease but the midterm and long-term results are still to be confirmed. Patient selection for the best treatment modality is the key to success of treatment of HCC. The purpose of current review is to provide a description of the current advances in diagnosis, staging, pre-operative liver function assessment and treatment options for patients with HCC in the east.
Collapse
|
4
|
Shah KN, Clary BM. Endoscopic and Percutaneous Approaches to the Treatment of Biliary Tract and Primary Liver Tumors. Surg Oncol Clin N Am 2014; 23:207-30. [DOI: 10.1016/j.soc.2013.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
5
|
Ihnát P, Ihnát Rudinská L, Zonča P. Radiofrequency energy in surgery: state of the art. Surg Today 2013; 44:985-91. [PMID: 23728491 DOI: 10.1007/s00595-013-0630-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 04/30/2013] [Indexed: 12/30/2022]
Abstract
Over a period of more than 100 years, radiofrequency energy has been introduced in many fields and applications in medicine. At present, radiofrequency constitutes the basis of numerous medical devices employed in almost all medical specialties. It is particularly applicable and valuable in various minimally invasive procedures for its locally focused effects. Radiofrequency energy is a technical term established to describe high-frequency alternating electrical currents (with a frequency ranging from 300 kHz to 3 MHz) and their impact on biological tissue. The application of RF energy causes controlled tissue heating with consequent cell protein denaturation and desiccation, which leads to cell death and tissue destruction. The primary principle of radiofrequency is that the generated heat can be used to cut, coagulate or induce metabolic processes in the target tissue. The authors of this paper offer a comprehensive and compact review of the definition, history, physics, biological principles and applications of radiofrequency energy in current surgery.
Collapse
Affiliation(s)
- Peter Ihnát
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic,
| | | | | |
Collapse
|
6
|
Macatula TC, Lin CC, Lin CJ, Chen WT, Lin SM. Radiofrequency ablation for hepatocellular carcinoma: use of low vs maximal radiofrequency power. Br J Radiol 2011; 85:e102-9. [PMID: 21427178 DOI: 10.1259/bjr/85505073] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES To investigate whether radiofrequency (RF) ablation with low power (LP) or maximal power (MP) for hepatocellular carcinoma (HCC) can achieve optimal ablation and fewer adverse effects. METHODS RF ablation was performed with MP in 101 patients (129 tumours) and with LP in 46 patients (61 tumours). MP RF ablation used power of >120 W. RF power below this was designated as LP. Clinical outcomes were also analysed in subgroups of high-risk tumours near the bile duct and blood vessels. RESULTS Primary effectiveness was achieved in 91.8% in the LP group and 89.9% in the MP group (p = 0.795). 1 and 2-year local tumour progression rates were 28% and 30%, respectively, in the LP group, and 24% and 29%, respectively, in the MP group (p = 0.70). 1 and 2-year survival rates were 98% and 98%, respectively, in the LP group, and 93% and 90%, respectively, in the MP group (p = 0.216). The MP group had more adverse effects, with post-RF ablation syndrome, asymptomatic pleural effusion and ascites, than the LP group (20% vs 39% in the MP group; p = 0.027); however, there was no significant difference in major complication rates (6% in the MP and LP groups; p = 0.497). Among the patients with high-risk tumours, RF ablation using MP vs LP was comparable in primary effectiveness (91.7% vs 95.2%; p = 0.618), local tumour progression (42.9% vs 29.2%; p = 0.304) and overall complications (5% vs 8%; p=0.618). CONCLUSION RF ablation with LP and MP are comparable in clinical outcomes but considerably fewer adverse effects were encountered in the LP group.
Collapse
Affiliation(s)
- T C Macatula
- Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
| | | | | | | | | |
Collapse
|
7
|
Koreckij TD, Hill C, Azure L, Nguyen H, Kunz LL, Azure A, Corey E, Lange P, Vessella RL. Low dose, alternating electric current inhibits growth of prostate cancer. Prostate 2010; 70:529-39. [PMID: 19938042 DOI: 10.1002/pros.21087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A number of minimally invasive technologies exist for the treatment of prostate cancer (CaP), each with their associated morbidities. We sought to test the efficacy of low dose alternating electric current (LDAEC) to inhibit CaP growth in a preclinical setting and determine its effect on normal tissue. METHODS In the first study, two power settings, 15 or 25 mA of current, and two treatment times, 15 or 60 min, were evaluated in C4-2B CaP xenografts. In the second study, power was regulated to maintain an intra-tumoral temperature of <or=45 degrees C in C4-2B and LuCaP 35 tumors. In both studies, tumor volume, serum PSA levels, survival and histology were analyzed. In a third study, LDAEC was applied to mice hamstrings with evaluation of gait and histology. RESULTS The most effective tumor volume reduction in the first study was seen with tumors treated with 25 mA for 15 min (62 +/- 9.4% decrease, P = 0.001). Longer treatment time did not enhance treatment effect. Using 45 degrees C to govern delivery of LDAEC resulted in a near 100% reduction in tumor volume in 8/10 mice with C4-2B tumors (P < 0.001) with similar inhibition of LuCaP 35 tumors (P = 0.01). This treatment, although resulting in skeletal muscle necrosis, did not affect nerves, smooth muscle and blood vessels. CONCLUSION LDAEC demonstrates efficacy against C4-2B and LuCaP 35 CaP xenografts while causing no harm to nerves and blood vessels. These results warrant further investigations into the use of LDAEC as a treatment for CaP.
Collapse
Affiliation(s)
- Theodore D Koreckij
- Department of Urology, University of Washington, Seattle, Washington 98195, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
|
9
|
Morel O, Monceau E, Tran N, Malartic C, Morel F, Barranger E, Côté JF, Gayat E, Chavatte-Palmer P, Cabrol D, Tsatsaris V. Radiofrequency ablation of retained placenta accreta after conservative management: preliminary evaluation in the pregnant ewe and in normal human placenta in vitro. BJOG 2009; 116:915-22. [DOI: 10.1111/j.1471-0528.2009.02166.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
10
|
Shah S, Kapoor A, Ding J, Guion P, Petrisor D, Karanian J, Pritchard WF, Stoianovici D, Wood BJ, Cleary K. Robotically assisted needle driver: evaluation of safety release, force profiles, and needle spin in a swine abdominal model. Int J Comput Assist Radiol Surg 2008. [DOI: 10.1007/s11548-008-0164-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
11
|
Morel O, Tran N, Barranger E, Foliguet B, Marchal F, Chastant-Maillard S, Judlin P, Villemot JP, Thiebaugeorges O. Radiofrequency driven cord occlusion for selective termination of pregnancy: evaluation in the fetal sheep. Am J Obstet Gynecol 2008; 198:227.e1-5. [PMID: 18068143 DOI: 10.1016/j.ajog.2007.07.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Revised: 07/02/2007] [Accepted: 07/24/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study was designed to assess the ability of an ultrasound-guided radiofrequency (RF)-driven procedure to induce complete and irreversible cord occlusion using a 90 days fetal sheep model. STUDY DESIGN Twenty 90 days gestation sheep underwent general anesthesia. The first ten fetuses were exposed under hysterotomy, and RF electrode was inserted visually in the middle of the umbilical cord and deployed. Fetuses were then replaced into the amniotic fluid and RF procedure (average target temperature of 100 degrees C during 10 minutes) was applied. For the next ten fetuses, RF electrode was inserted into the cords under trans-parietal ultrasound guidance and the same RF procedure was applied. Cord occlusion was assessed by Doppler examination (absence of cordonal flows at the end of the procedure and until fetal heart failure occurred) and by subsequent histopathological analysis. RESULTS Cord occlusion was always complete at Doppler examination at the end of RF procedure for the ten experiments realized under hysterotomy. No cordonal reperfusion was observed until fetal heart failure. Histopathological analysis confirmed cordonal occlusion at the site of impact. Neither cordonal rupture nor cordonal bleeding was observed for any of the ten experiments. When RF electrode was inserted under ultrasound guidance, complete occlusion could be obtained only for 6 of the ten experiments. CONCLUSION Our results suggest that RF might be an appropriate method for selective termination of pregnancy. Yet, optimal insertion of the electrode is required to engender a complete and irreversible cord occlusion, and ultrasound-guidance training seems necessary before current human application.
Collapse
|
12
|
Martin AP, Goldstein RM, Dempster J, Netto GJ, Katabi N, Derrick HC, Altrabulsi B, Jennings LW, Ueno T, Chinnakotla S, Dawson S, Randall HB, Levy MF, Onaca N, Sanchez EQ, Orr D, Klintmalm GB. Radiofrequency thermal ablation of hepatocellular carcinoma before liver transplantation--a clinical and histological examination. Clin Transplant 2007; 20:695-705. [PMID: 17100718 DOI: 10.1111/j.1399-0012.2006.00538.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) is an optional treatment for patients awaiting liver transplantation (LTX). The study evaluates the efficacy of RFA in the explanted liver and its effect on patient outcome. MATERIAL AND METHOD Forty-seven patients underwent RFA and were listed for transplant between January 1998 and May 2003. The patients were divided into two groups: transplanted and non-transplanted. Both groups were evaluated in terms of tumor characteristics, recurrence, mortality rate, and time on the waiting list. The ablation sites in the explanted livers were examined for percentage of necrosis by Hematoxylin & Eosin (H&E) stain and by TUNEL stain. RESULTS Transplantation was carried out in 35 patients (74.5%). Ten patients (21.3%) died before transplant or were removed from the wait list, while two patients (4.2%) are still listed. Mortality and tumor-related mortality were significantly higher in the non-transplanted group. The time spent on the waiting list was longer in the non-transplanted patients (350 vs. 186 d average, p = 0.0345). Thirty-eight ablation sites were examined in the explanted livers. The percentage of tumor necrosis by TUNEL staining was 19.6% higher than that reported by H&E staining. After TUNEL staining, 28 sites (73.7%) had more than 90% necrosis, eight sites (21.0%) had 50-90%, and two sites (5.3%) had less than 50% necrosis. CONCLUSIONS RFA and LTX can be used successfully in HCC patients, and in most cases, tumor necrosis can be achieved with ultrasound-guided RFA. H&E stain tends to under-represent the amount of tumor necrosis on the ablation sites. Survival of RFA patients after LTX is excellent.
Collapse
|
13
|
Morel O, Tran N, Marchal F, Hennequin V, Foliguet B, Villemot JP, Thiebaugeorges O. Ultrasound-guided radiofrequency-driven umbilical cord occlusion: an in-vitro study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2006; 28:187-92. [PMID: 16628610 DOI: 10.1002/uog.2691] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVES To assess the ability and safety of radiofrequency (RF) to induce cord thermal lesions using in-vitro perfused umbilical cords. METHODS Nineteen human term umbilical cords were cannulated at both ends and perfused continuously with saline serum in a saline serum bath (37 degrees C). The RF electrode was then inserted into the cord close to the umbilical vein. Different RF power and temperature controls were applied to determine the optimal RF procedure in terms of cord tissue injury and safety in nine experiments. The safety of RF procedures was investigated in ten cords by measuring temperature changes at different sites close to the RF electrode insertion and the impact of RF on cord narrowing was evaluated by continuous monitoring of intraluminal pressure. Subsequent histopathological analysis was carried out in all cases. RESULTS The optimal RF procedure reached a temperature of 100 degrees C in 10 min. RF produced a significant increase in intraluminal pressure (from 54.2 +/- 16.4 mmHg at baseline to 118.3 +/- 42.7 mmHg after 10 min, P < 0.05). There was no significant increase in temperature next to the site of insertion during the RF procedure. Histopathological analysis confirmed a > 30% decrease in cord and vein diameter. Cord tissue lesions were characterized by damage in the vessel walls and in the surrounding Wharton's jelly. CONCLUSION Our results suggest that RF might be a feasible and safe technique to induce occlusion of umbilical vessels. Further in-vivo experiments are needed to assess its ability to induce a complete occlusion of the umbilical cord.
Collapse
Affiliation(s)
- O Morel
- Laboratory of Surgery School, Faculty of Medicine, Comprehensive Cancer Center, Nancy, France.
| | | | | | | | | | | | | |
Collapse
|
14
|
Locke J, Zeug A, Thompson D, Allan J, Mazzarella K, Novak P, Hanson D, Singh AK, Moros EG, Pandita TK. Localized versus regional hyperthermia: comparison of xenotransplants treated with a small animal ultrasound system and waterbath limb immersion. Int J Hyperthermia 2005; 21:271-81. [PMID: 16019853 DOI: 10.1080/02656730500070151] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The response of xenotransplants were compared with waterbath immersion vs focal ultrasound (US) hyperthermia using tumour growth delay, immunhistochemistry and histopathology assays. Waterbath hyperthermia was performed by limb immersion. Precautions were taken to minimize total body heating by surrounding the mouse with plastic insulators. Thermometry was performed with clinical-grade, 20-gauge needle thermocouples and monitored with a Labthermics unit. Significant differences in cytotoxicity between ultrasound and waterbath treatment of tumors at 43 degrees C were observed as determined by TUNNEL assay. Conversely, contralateral (non-treated) tumours in animals treated with similar temperature demonstrated no significant differences between modalities. Western blot analysis revealed increased hsp70 induction at 43 degrees C in waterbath vs focal ultrasound hyperthermia. Comparison of tumour growth delay between tumours heated with waterbath vs ultrasound at 43 degrees C but not at 41 degrees C revealed significant differences. This is the first study comparing localized vs regional hyperthermia using the small animal ultrasound system (SAHUS) delivery system. Consistent ultrasound hyperthermia can be achieved throughout a xenotransplant. At equivalent temperature of 43 degrees C for 60?min, waterbath hyperthermia demonstrated greater local response vs ultrasound hyperthermia.
Collapse
Affiliation(s)
- J Locke
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63108, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
There is no worldwide consensus of an algorithm for the radical treatment of hepatocellular carcinoma (HCC). Surgical resection, liver transplantation and, recently, local ablation therapies achieve high curative rates in selected patients. However, recurrence of HCC remains a major problem. This review provides an overview of the current surgical treatment options available for patients with HCC.
Collapse
Affiliation(s)
- Lucas McCormack
- The Department of Visceral and Transplant Surgery, University Zürich, Switzerland
| | | | | |
Collapse
|
16
|
Dixon E. Commentary. J Surg Oncol 2005. [DOI: 10.1002/jso.20205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|